Why is it bad to mix antidepressants and alcohol?

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

It's generally best to avoid combining antidepressants and alcohol. It may worsen your symptoms, and in some cases it can be dangerous. Here are a few things that might happen if you do mix antidepressants and alcohol:

  • You may feel more depressed. Alcohol can worsen depression symptoms. 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.
  • 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 drive or do other tasks that require focus and attention.
  • Side effects may be worse if you also take another medication. A number of medications can cause problems when taken with alcohol — including anti-anxiety medications, sleep medications and prescription pain medications. Drowsiness or other side effects may be even more pronounced if you drink and take one of these drugs along with an antidepressant.
  • You may become sedated or feel drowsy. Some antidepressants cause sedation and drowsiness, and so does alcohol. When taken together, the combined effect can be intensified.
  • If you take MAOIs, you may be at risk of a dangerous reaction. When combined with certain types of alcoholic beverages and foods, monoamine oxidase inhibitor (MAOI) antidepressants can cause a dangerous spike in blood pressure. Examples of MAOIs include isocarboxazid (Marplan), phenelzine (Nardil) and tranylcypromine (Parnate). 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.
  • 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.

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. 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, including herbal supplements.

Jul. 21, 2011