The dangers of drinking while taking antidepressants

Antidepressant usage across Europe and the rest of the world has increased significantly over recent years. The Organization for Economic Cooperation and Development (OECD) released data showing use of antidepressants increased by nearly two and a half times between 2000 and 2020 in 18 European countries and as of 2025, one-in-six adults in Europe and North America take antidepressants. As a consequence of this seismic shift, millions of individuals are recalibrating their lifestyles and making positive habitual adjustments to sleep, stress, mindset and nutrition. But often among the most pertinent, is in establishing a clear approach with antidepressants and alcohol.

When it comes to combining antidepressants and alcohol, the outcomes range from unfavourable, to extremely unsafe. Judging how much alcohol is safe to drink on antidepressants can be difficult and inaccurate, with individuals’ response to medications varying considerably. Full abstinence from drinking alcohol whilst taking antidepressants is the safest practice, though understandably, those on long-term prescriptions of antidepressants will experience times of wanting to enjoy an alcoholic beverage. In those cases of potential mixing antidepressants and alcohol, it is imperative to follow the official guidance of each specific medication.

Can I drink alcohol while on antidepressants?

Medical advice overwhelmingly warns against mixing alcohol and antidepressants. Concerns are well-substantiated that the combination of alcohol with antidepressants can exacerbate the onset of side effects such as drowsiness, dizziness and impaired physical capability. There is also evidence that taking some antidepressants and alcohol together can result in hypertensive stroke, heart palpitations, and changes in blood pressure.

Concerns about food and drug interactions with Monoamine oxidase inhibitors (MAOI) antidepressants have prompted medical papers calling for reconsideration in prescriptions of the drugs. The first class of antidepressant medications to be manufactured and distributed, MAOIs such as Nardil, Parnate and Marplan are highly effective but extremely dangerous antidepressants when taken with alcohol. This is because MAOI antidepressants block the body’s natural enzyme ability that metabolizes the chemical compound tyramine - a byproduct in fermented food and drinks like beer and wine. If a person on MAOIs consumes high-tyramine foods or beverages, tyramine levels in the body can build up rapidly, leading to a potentially fatal condition known as a hypertensive crisis.

Drinking alcohol while taking antidepressants can not only exacerbate side-effects but can also block the effects of the medication itself, therefore causing the symptoms associated with depression worse. A wealth of research indicates that even low levels of alcohol consumption, by individuals being treated for depression, may reduce the antidepressant’s effectiveness, lessen the individual’s commitment to taking the medication consistently and cause an increase in erratic or emotionally driven behavior. The European Medicines Agency, (EMA) consistently advises high caution and avoidance of taking antidepressants with alcohol on the grounds of worsening side-effects, compromising the benefits of the chosen medication and longer-term complications with anxiety and depression. They have produced an extensive and up-to-date guide on clinical evidence for medication for depression that include interactions with alcohol.

SSRIs and alcohol

Selective Serotonin Reuptake Inhibitors (SSRIs) are a modern and ubiquitous type of antidepressant. Serotonin is a chemical messenger or neurotransmitter that affects mood and SSRIs help to restore the natural balance of serotonin in the brain. Doctors consider SSRIs to be one of the safest types of antidepressants and thus, they have become the most widely prescribed class of antidepressants. Branded variants include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft).

Despite their safety record, both pharmaceutical manufacturers and medical experts discourage mixing SSRIs and alcohol. One reason for this is that a significant number of people experience a marked change in alcohol tolerance during treatment with SSRIs, called pathological alcohol intoxication. There are calls for guidelines for and SSRI antidepressants and alcohol to be strengthened to clearly and fully warn both prescribers and patients about the possibility of pathological alcohol intoxication.

Can I drink alcohol on Zoloft?

Usage guidelines from Zoloft pharmaceutical manufacturer guidelines state that you should not drink alcohol while you take Zoloft as it may likely reduce Zoloft's effectiveness, amplify adverse side-effects and increase health risks.

Can I have an occasional drink while on Lexapro?

Consult your healthcare provider for individual advice on taking alcohol with Lexapro but healthcare professionals do not generally recommend that people drink alcohol while taking Lexapro. This guidance is because alcohol can not only negate the intended benefits of taking antidepressants but also worsen cases of depression as well. This means those who combine alcohol and antidepressants like Lexapro may feel even more depressed or anxious, than they would naturally.

Can I drink alcohol while taking Wellbutrin®?

According to the Stanford Neurodevelopment Affect and Psychopathology Laboratory, both alcohol and antidepressants like Wellbutrin® increase the possibility of seizures. The associations require further clarification but another avenue of thought for this is that those who drink a significant amount of alcohol, are often advised to stop drinking before starting taking Wellbutrin®. However, if you drink a lot and then suddenly stop, you can also increase the risk of seizures.

Why is it bad to mix antidepressants and alcohol?

Although some people experience an initial lift in mood when they mix antidepressants and alcohol, it is often short-lived before having the adverse effect of worsening symptoms of depression and anxiety. In addition, there is strong evidence that drinking alcohol with antidepressants can cause any registered side effects to worsen. Most commonly, people can find it increasingly difficult to think clearly, stay alert, and have trouble sleeping come bed time.

Overall, in combining antidepressants and alcohol the outcomes become far harder to predict and any short-term pleasure is quickly replaced by the likelihood of longer term harm.

Legal but harmful

Though it is legal to take antidepressants with alcohol, the professional guidance against doing so is robust and evidential. The outcomes can be adverse, unpredictable and potentially dangerous, so medical experts warn strongly against taking antidepressants with alcohol together.

Can I skip a day of antidepressants to drink?

Doctors strongly recommend that people do not stop taking antidepressants in order to drink alcohol. Skipping a day of antidepressants to drink alcohol is highly risky and there is no way to monitor the current active dose in your body. Interviewed for CNN, family physician Dr. Jill Grimes, explains, “Antidepressants don’t go into and out of your system in a few hours. It takes many days or weeks. Skipping a dose will not decrease your risk of interaction with alcohol and may result in you having headaches, nausea and increased anxiety or flu-like symptoms from antidepressant discontinuation syndrome.”

Antidepressant for heavy drinkers

Though taking antidepressants and alcohol is fervently discouraged by the global medical community, those undergoing residential treatment for Alcohol Use Disorder (AUD) are often given antidepressants for co-occurring depression symptoms and withdrawal symptoms.

However, this is to counteract the effects of depression itself, not the individual’s relationship with alcohol or addiction issues.

Alcohol disorders

For some it’s a way to celebrate, relax or unwind, for others alcohol carries far more complexity. Antidepressants are one of the most prescribed medications in patients with Alcohol Use Disorder (AUD) and yet, a 2018 Cochrane review concluded there was low-quality evidence supporting the clinical use of antidepressants in the treatment of people with alcohol dependence. Furthermore, an extensive Harvard Medical School review into the existing studies on taking antidepressants to reduce alcohol intake, showed that more specific investigation was required to support any positive relationship between antidepressants and alcohol disorders.

Alcohol-induced depression

Studies show that people with alcohol dependence are 3.7 times more likely to also have major depressive disorder, making antidepressants a widely accepted treatment for alcohol-induced depression. Indeed, clinical research demonstrates that in cases of using antidepressants with alcohol-induced depression, occurrences of relapses in abstinence were reduced by the antidepressants changing depression symptoms. The crux being that though antidepressants do not alleviate issues for those with substance addiction problems, they are proven effective for the root depression that may cause an individual to drink alcohol to excess.

There is a well-proven direct correlation between those who drink alcohol to excess and experience symptoms of depression. Chronic alcohol use and its related life problems can lead to depressive symptoms and studies suggest the role of alcohol in causing major depression is likely to be stronger than the reverse. It is therefore highly recommended that heavy drinkers and those with alcohol disorders receive psychiatric therapy for their depression symptoms and to address the root causes behind negative relationships with alcohol, rather than relying solely on the predominantly unsubstantiated support of antidepressant medication.

Do antidepressants make you less tolerant to alcohol?

Research finds that even those who do not have issues with alcohol can experience “markedly exaggerated intoxication or qualitatively different intoxication.” Although not an absolute, this pathological intoxication is far from rare and can have serious consequences.

Among the concerns for mixing antidepressants and alcohol is that medication can make you less tolerant to alcohol and change your reaction times and severity to consuming it. How this impacts on an individual scale can differ enormously. Recent 2025 medical papers published in The Lancet, have highlighted that the side effects of antidepressants vary significantly from one medication to another, and there is no ‘one size fits all’ advice to how the body might react physically within days, weeks or even months. Researchers are now calling for antidepressant treatment guidelines to be updated to reflect these findings, including how different antidepressants might affect tolerance to alcohol.

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What to avoid while on antidepressants?

Upon concluding treatment, Kusnacht Practice designs an onwards treatment plan for each guest, so they leave with a deeper understanding of depression and the tools to build a more fulfilling life. Knowing what to avoid while on antidepressants, including the dangers of alcohol, alongside awareness of how to avoid relapse are invaluable in reaching complete confidence that you can become the best version of yourself.