Everything You Should Know About Antidepressants and Alcohol

An estimated 3.8% of the worldwide population is affected by depression. This particular mental health condition can cause prolonged feelings of sadness, hopelessness, and guilt, and interfere with daily life.

It can also cause symptoms of apathy toward previously enjoyable activities, difficulty making decisions, physical issues, and thoughts of self-harm and suicide.

To help treat these symptoms, doctors may prescribe antidepressants. 

Similar to any type of medication, antidepressants may cause side effects, some of which include nausea, insomnia, irritability, fatigue, and dry mouth.

These common side effects are typically mild and go away after a few weeks. However, consuming alcohol while taking antidepressants can lead to serious side effects. 

In this article, I’ll discuss what antidepressants are and who they may be helpful for. I’ll also explain different types of antidepressants and go over warnings of mixing antidepressants and alcohol.

Finally, I’ll explore what to discuss with a doctor for tips to manage antidepressant side effects.

What Are Antidepressants?

Antidepressants are prescribed medications that are used to treat depression, anxiety, and other mental health disorders.

Low levels of neurotransmitters that are associated with depression include serotonin, norepinephrine, and dopamine.

These chemicals work in different ways to help with your mental and physical well-being. Most antidepressants work by increasing the low levels of these important neurotransmitters. 

Who takes antidepressants?

People diagnosed with depression and other mental health disorders commonly take antidepressants to help treat its symptoms.

Research shows adolescents and young adults in the United States experience depression symptoms at a higher rate than other age groups, people at any age can get depression.

Additionally, people with vaginas are more likely to get depression than people with penises. However, anyone can suffer from depression. 

Types of antidepressants 

The following are types, or classes of antidepressants that your doctor can prescribe you:

• Selective serotonin reuptake inhibitors (SSRIs): A common first-line treatment for symptoms of depression, SSRIs increases the level of serotonin in your body by preventing the reabsorption (or reuptake) after communicating to a cell receptor. Serotonin is an important hormone that helps regulate appetite, improve sleep, and balance emotions. Common brands of SSRIs that the Food and Drug Administration name include Zoloft (sertraline), Paxil (paroxetine), Lexapro (escitalopram), Clexa (citalopram), and Luvox (fluvoxamine).

• Serotonin and norepinephrine reuptake inhibitors (SNRIs): Similar to SSRIs, SNRIs work to increase levels of serotonin by blocking its absorption. They also increase levels of norepinephrine, a chemical that helps with mood regulation, sleep, memory, and concentration. FDA-approved SNRI brands are: Pristiq (desvenlafaxine), Cymbalta (duloxetine), and Effexor (venlafaxine). 

• Monoamine oxidase inhibitors (MAOIs): Introduced before SSRIs and SNRIs, MAOIs stop monoamine oxidase, a brain enzyme, from breaking down serotonin, norepinephrine, and dopamine. They’re not as commonly prescribed now due to their potential serious side effects. Brands of MAOIs that the FDA has approved include: Marplan (isocarboxazid), Parnate (tranylcypromine), Emsam (selegiline), and Nardil (phenelzine).

• Tricyclic Antidepressants (TCAs): TCAs, which get their name from the three rings in their chemical structure, are another older class of antidepressants. They block the reuptake of serotonin and norepinephrine, increasing their levels in the brain. As with MAOIs, they’re not as commonly prescribed as SNRIs and SSRIs since they have  more side effects. FDA-approved TCAs include Tofranil (imipramine), Pamelor (nortriptyline), and Nopramine (desipramine).

• Atypical Antidepressants: These types of medications don’t fall in line with any of the other classes of antidepressants. However, they function in a similar way. They affect brain chemistry, increasing levels of dopamine, serotonin, or norepinephrine. They can increase one or more of these neurotransmitters. Common brands the FDA has approved are: Wellbutrin (bupropion), Viibryd (vilazodone), and Remeron (mirtazapine).

Warnings of Mixing Antidepressants and Alcohol  

It is recommended that you don’t drink alcohol while taking antidepressants, as it may increase the risk of worsening mild to serious symptoms of antidepressants. 

Counteracting the effects of antidepressants 

Consuming alcohol while taking antidepressants may prevent you from experiencing the benefits of antidepressants.

While it may feel good at the moment, drinking while on antidepressants may cause symptoms of depression. 

Substance use disorder

A substance abuse disorder is a mental disorder that makes it difficult for people to control their use of substances like alcohol.

It is common for people with alcohol dependence to also have depression.

So although it’s not recommended to take antidepressants with alcohol, it’s important to weigh the benefits and risks of antidepressants as treatment.

One study found that for people with co-occurring depression and alcohol dependence, the risk of developing adverse effects from antidepressants is minimal, especially with SSRIs.

So antidepressants may be a good treatment option, depending on your doctor’s assessment. 

Another study showed that people with penises who were depressed consumed less alcohol during the first year they took antidepressants than the year before they started taking them.

But more research is needed to see if the results were from antidepressants or another factor, and why the effect was only found with people with penises and not those with vaginas. 

Worsening antidepressant side effects

Drinking alcohol while taking antidepressants may exacerbate their side effects, especially if you are also taking other medications that can have negative interactions with alcohol, like sleep medications and prescription pain medications.

Avoid drinking alcohol if you’re taking Wellbutrin, for example, since this may lead to uncommon and serious side effects, including hallucinations, paranoia, mood and behavioral changes, anxiety, panic attacks, suicidal thoughts, and seizures.

If you drink a lot of alcohol and then suddenly stop drinking while taking Wellbutrin, this may also increase risk of seizures. 

Intensifying effects of alcohol  

Taking antidepressants with alcohol can intensify certain effects that can be caused by both the medication and alcohol.

For instance, you may feel extremely drowsy and less mentally alert when consuming alcohol and antidepressants.  

Risk of dangerous interaction with MAOIs

MAOIs are typically a second-line prescription for depression when other classes of antidepressants aren’t working, as they interact with other medications and food, causing adverse side effects.

Taking MAOIs and consuming certain alcohols may cause a serious blood pressure spike.   

Talk to a Doctor for Tips to Manage Antidepressant Side Effects

Although side effects for antidepressants are typically mangable and short term, combining alcohol and antidepressants can lead to serious side effects.

It’s important to speak with your doctor about any side effects you may be having.

If you’re having thoughts of self-harm or suicide, call the National Suicide Prevention Lifeline at 988.

If you’re suffering from substance abuse, you can reach the Substance Abuse and Mental Health Services (SAMHSA) National Helpline at 1-800-662-4357.  

Whether you want to discuss side effects of antidepressants or treatment for depression, K Health can help.

Did you know you can get affordable primary care with the K Health app? Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a provider in minutes. K Health’s AI-powered app is based on 20 years of clinical data.