Antidepressants and alcohol: What’s the concern?

It’s best not to combine antidepressants and alcohol. When you combine the two, symptoms may worsen, and it can be dangerous. If you mix antidepressants and alcohol:

• You may feel more depressed or anxious. Alcohol can stop the benefits of your antidepressant medicine, making your symptoms harder to treat. Alcohol may seem to make your mood better in the short term. But its overall effect makes symptoms of depression and anxiety worse.
• Side effects may worsen. Alcohol can raise the side effects of antidepressants. Other medicines, including those for anxiety, sleep and pain, also can cause problems when taken with alcohol. Side effects may worsen even more if you drink alcohol and take one of these other medicines along with an antidepressant.
• You may have a harmful reaction if you take an MAOI. When taken with certain alcoholic beverages and foods, antidepressants called monoamine oxidase inhibitors, also known as MAOIs, can cause a dangerous spike in blood pressure. If you take an MAOI, be sure you know what’s safe to eat and drink and which alcoholic beverages are likely to cause a reaction.
• It may be hard to think clearly or stay alert. The mix of antidepressants and alcohol affects your judgment, coordination, motor skills and reaction time more than alcohol alone. Some mixtures may make you sleepy. This can affect your ability to drive or do other tasks that require focus and attention.
• You may get sleepy. Some antidepressants cause you to feel sleepy. Alcohol also can make you feel sleepy. When taken together, the combined effect can be much stronger and potentially dangerous.

Don’t stop taking an antidepressant or other medicine so you can drink. For antidepressants to work as intended, you need to take them regularly to have a constant level in your system. Stopping and starting your antidepressants can make your depression worse. Doing so also could cause symptoms related to the stopping of antidepressants unless you follow medical advice.

While it’s generally best not to drink at all if you’re depressed, ask your healthcare professional if alcohol is safe for you. If you have depression:

• You may be at risk of alcohol misuse. People with depression are at higher risk of substance misuse and addiction. If you have trouble controlling your alcohol use, you may need treatment for an alcohol use disorder before your depression gets better.
• You may have trouble sleeping. Some people who are depressed have trouble sleeping. Using alcohol to help you sleep may let you fall asleep quickly, but your sleep will be more disturbed in the middle of the night.

If you have concerns about your alcohol use, counseling and treatment programs can help you overcome your misuse of alcohol. Joining a support group or a 12-step program such as Alcoholics Anonymous may help.

If you’re at low risk of addiction to alcohol, it may be OK to have an occasional drink. But this depends on your situation. Ask your healthcare professional for guidance.

Also, tell your healthcare professional about any other health conditions you might have and any other medicines you take. This includes medicines available without a prescription and supplements.

Keeping your healthcare professional informed is important because:

• Some liquid medicines such as cough syrups contain alcohol.
• As you age, your body processes medicine differently, so the amount of medicine you take may need to change.
• Adding a new medicine may change the level of another medicine in your body and how it reacts to alcohol.