Why is it bad to mix antidepressants and alcohol?

Answers from Daniel K. Hall-Flavin, M.D.

It's best to avoid combining antidepressants and alcohol. It may worsen your symptoms, and in some cases it can be dangerous. If you mix antidepressants and alcohol:

  • You may feel more depressed or anxious. Drinking can counteract the benefits of your antidepressant medication, making your symptoms more difficult to treat. Alcohol may seem to improve your mood in the short term, but its overall effect increases symptoms of depression and anxiety.
  • Side effects may be worse if you also take another medication. Many medications can cause problems when taken with alcohol — including anti-anxiety medications, sleep medications and prescription pain medications. Side effects may worsen if you drink alcohol and take one of these drugs along with an antidepressant.
  • You may be at risk of a dangerous reaction if you take MAOIs. When combined with certain types of alcoholic beverages and foods, antidepressants called monoamine oxidase inhibitors (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.
  • Your thinking and alertness may be impaired. The combination of antidepressants and alcohol will affect your coordination, judgment and reaction time (motor skills) more than alcohol alone. Some combinations may make you sleepy. This can impair your ability to drive or do other tasks that require focus and attention.
  • You may become sedated or feel drowsy. A few antidepressants cause sedation and drowsiness, and so does alcohol. When taken together, the combined effect can be intensified.

Don't stop taking an antidepressant or other medication just so that you can drink. Most antidepressants require taking a consistent, daily dose to maintain a constant level in your system and work as intended. Stopping and starting your medications can make your depression worse.

While it's generally best not to drink at all if you're depressed, ask your doctor. If you have depression:

  • You may be at risk of alcohol abuse. People with depression are at increased risk of substance abuse and addiction. If you have trouble controlling your alcohol use, you may need treatment for alcohol dependence before your depression improves.
  • 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 you tend to wake up more in the middle of the night.

If you're concerned about your alcohol use, you may benefit from substance abuse counseling and treatment programs that 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, depending on your particular situation. Tell your doctor about any other health conditions you might have and any other medications you take, such as herbal or other supplements.

Jun. 12, 2014