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If you’re on an antidepressant, you might be wondering if it is safe to drink alcohol. In general, it’s best to avoid mixing antidepressants and alcohol.

Here’s what you need to know about antidepressants and drinking alcohol.

Why Doctors Prescribe Antidepressants

Doctors mostly prescribe antidepressants for treating depression. But your doctor may also prescribe for other mental health issues, including:

  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Social phobia

Doctors may also prescribe antidepressants for off-label use for other health issues, including chronic pain.

Taking an antidepressant is often part of a long-term treatment plan to get well and stay well. Patients may take antidepressants while also receiving psychotherapy or counseling.

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How Do Antidepressants Work?

Different antidepressants work in different ways. But overall, antidepressants increase or restore levels of chemicals in the brain called neurotransmitters.

These chemicals help regulate mood and behavior by increasing communication between brain cells.

What Happens When You Combine Antidepressants and Alcohol?

There are several reasons why drinking alcohol while taking antidepressants is a bad idea.

Alcohol can worsen symptoms of depression

Alcohol is a depressant, which means it slows down your nervous system. For some people, alcohol — alone or with antidepressants — can make symptoms of depression worse. Taking both at the same time can also increase the risk of suicidal thoughts and action. That’s according to the National Alliance on Mental Illness (NAMI).

Alcohol can increase side effects of medication

Drinking alcohol while taking antidepressants can also increase the risk of medication side effects, particularly drowsiness. Other side effects of antidepressants that alcohol can worsen include:

  • Anxiety
  • Difficulty concentrating
  • Dizziness
  • Drowsiness
  • Headaches
  • Insomnia

Mixing alcohol and antidepressants can cause dangerous side effects

Doctors recommend avoiding drinking alcohol when taking any antidepressant. This is because doing so can cause dangerous side effects, such as a sudden drop in blood pressure. Mixing alcohol with antidepressants can also cause fatal toxicity if your liver can’t remove all the toxins of both substances.

The FDA specifically warns to use caution when drinking alcohol while using certain types of antidepressants. These include:

The atypical antidepressant Serzone™ (nefazodone)

There have been reports of life-threatening liver failure in patients taking nefazodone. This is a rare but serious side effect. Since your liver acts as a filter for alcohol, alcohol can place an additional burden on your liver.

The atypical antidepressant Wellbutrin® (bupropion SR and bupropion XL)

In some people, Wellbutrin® can increase the risk of having seizures. If you often drink a lot of alcohol, talk to your doctor before starting Wellbutrin® or before stopping drinking. If you drink a lot and then suddenly stop, you can also increase your risk of seizures.

Monoamine oxidase inhibitors (MAOIs)

MAOIs include Emsam® (selegiline), Marplan® (isocarboxzaid), Nardil® (phenelzine), and Parnate® (tranylcypromine). The FDA specifically warns against mixing high amounts of a substance called tyramine (found in many types of fermented alcohol, such as beer and wine) with MAOIs. This is because MAOIs prevent the breakdown of tyramine in the body, which can cause a sudden increase in blood pressure.

This is a rare side effect, but it can lead to bleeding in the brain, which could cause death.

Alcohol can interfere with treatment

Alcohol misuse can interfere with medication adherence — that is, taking your medication as directed. That’s according to information in StatPearls, a publication by the National Center for Biotechnology Information.

If you are struggling with alcohol use, UPMC Western Psychiatric Hospital can help. We offer inpatient and outpatient addiction treatments, counseling, and education. For more information, call 1-877-624-4100 or 412-624-1000.

Sources

Commonly Prescribed Antidepressants and How They Work. NIH MedlinePlus Magazine. National Institutes of Health. Link.

Depression Medicines. U.S. Food and Drug Administration. Link.

Antidepressants. StatPearls. National Center for Biotechnology Information. Link.

Wellbutrin XL. U.S. Food and Drug Administration. Link.

Monoamine Oxidase Inhibitors. StatPearls. National Center for Biotechnology Information. Link.

Medically Frequently Asked Questions. National Alliance on Mental Illness. Link.

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. UPMC Western Psychiatric is the hub of UPMC Western Behavioral Health, a network of nearly 60 community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors throughout western Pennsylvania.