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Mixing Antidepressants with Alcohol: A Dangerous Combo

Antidepressants and alcohol mix dangerously. They can severely impact motor skills when used together and elevate the risk of suicidal thoughts and actions. In some cases, the combination can severely impact the liver.

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Taking alcohol with an MAOI specifically is especially dangerous, increasing the risk of a stroke due to this combination’s ability to spike blood pressure.

Why Do People Mix Alcohol & Antidepressants?

The use of multiple drugs together is called polydrug or polysubstance use. The reason people might mix alcohol and antidepressants isn’t well studied, but there are a few reasons people engage in polydrug use even when the drugs they’re using are known to have potentially dangerous interactions.

Unaware of Risks

The first is simply that a person isn’t aware of a given interaction. Some people may be using antidepressants and also decide to drink alcohol recreationally, not realizing that being on antidepressants can make alcohol use more dangerous. 

Alcohol Abuse 

Others may struggle with alcohol use and have difficulties stopping drinking even if they’ve been prescribed medications that can interact dangerously with alcohol. These individuals would likely qualify as having an alcohol use disorder, often just called alcohol addiction. If people are unable to reduce alcohol use and regain control over drinking on their own, it’s a sign that help is needed.

Self-Harm

Some people mix antidepressants and alcohol as a form of self-harm, trying to hurt themselves through a dangerous combination of drugs. By the nature of these drugs, many people taking antidepressants are at greater risk of self-harm. 

Additionally, some people may have a relatively rare reaction to antidepressants that makes them consider self-harm when they normally would not. This is why it’s very important to talk to a doctor if you experience thoughts of suicide or other types of self-harm when on a new medication. 

Euphoria

Finally, some people may mix alcohol and antidepressants in an attempt to achieve an altered state that is not normally possible when only taking antidepressants or drinking alcohol. The goal is often to achieve a state of euphoria or feeling good.

Risks & Dangers of Combining These Substances

Antidepressants and alcohol make a user drowsier, less alert, and less coordinated. When used in combination, these symptoms can become severe. 

This combination can seriously impact motor skills and make normally commonplace tasks very dangerous, such as driving (even if someone hasn’t consumed enough alcohol that it would normally be illegal to drive). Combining these drugs can also heavily tax the liver and sometimes cause fatal toxicity to occur. 

Alcohol is also notably a depressant and can reduce how effective antidepressants are at managing depression and anxiety symptoms. This can potentially lead to suicidal thoughts and actions when they otherwise would not have occurred.

Certain antidepressants called MAOIs can be very dangerous to take with alcohol. The combination can cause a spike in blood pressure, which can cause a stroke.

Another risk less often discussed is that some people will skip a dose of their antidepressant in order to drink alcohol more safely. While preferable to mixing these drugs together, experts note that this often leads to a patient skipping their medication for longer periods than just the one or two days they originally intended and relapsing back into their depression or anxiety symptoms. Without medication, some people with depression are at risk of self-harm.

Is It Ever Safe to Combine These Drugs?

Fundamentally, it isn’t safe to combine alcohol with antidepressants. While there are different levels of risk and harm depending on how heavily one drinks alcohol while on antidepressants, it is best to completely avoid alcohol when on antidepressants. 

If you can’t or won’t stop drinking alcohol completely, you should at least monitor your alcohol intake while on antidepressants and certainly talk to your doctor about your intention to drink. Some physicians will allow one drink per day for women and two drinks per day for men. Drinking much beyond that is reaching a point where it is difficult to medically justify a patient using antidepressants if they can’t first reduce their drinking.

Talk to a Doctor Before Taking Antidepressants With Alcohol

If you intend to drink alcohol while on antidepressants, talk to a doctor first. A doctor can help you thoroughly understand the risks involved, answer any questions you have, and clear up any misconceptions on the subject. They can also make sure that you aren’t being put on antidepressants that are especially likely to have a dangerous interaction with alcohol, such as MAOIs.

Remember that hiding your intention to drink from a doctor can be dangerous. They need to know what drugs you’re putting in your body when making prescribing decisions. If you don’t let your doctor know you intend to drink, you could be endangering your life.

A medical professional can also help you to reduce your drinking if you don’t feel you can stop on your own but want to. Alcohol addiction is a serious medical condition, and it is typically very difficult to get control over without medical intervention. Addiction treatment specialists can help you form a treatment plan to start gaining control over your alcohol use and reducing your drinking long term.

Most addiction treatment programs are equipped to treat co-occurring disorders, so your depression can be treated alongside your alcohol abuse issues. This is the best way to ensure full recovery on all fronts.

Updated August 23, 2023
Resources
  1. Polysubstance Use Facts. (February 2022.) Centers for Disease Control and Prevention.
  2. Frequently Asked Questions. National Alliance on Mental Illness.
  3. Is It Safe to Drink Alcohol While Taking S.S.R.I.s? (October 2022.) The New York Times.
  4. Antidepressants for the Treatment of People With Co‐Occurring Depression and Alcohol Dependence. (April 2018). Cochrane Database of Systematic Reviews.
  5. Alcohol Consumption and the Use of Antidepressants. (February 2007). CMAJ.
  6. Drinking Alcohol During Antidepressant Treatment — a Cause for Concern? (December 2011). The Pharmaceutical Journal.
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