Antidepressants and alcohol can effectively work against each other. The medication helps to steady your brain chemistry, and alcohol disrupts it. When you have both alcohol and antidepressants in your system, the medication can become less effective.
If you’re wondering whether it’s safe to have a drink while you’re on antidepressants, the short answer is that it’s safest not to. But the risks depend on which type of antidepressant you’re taking, and for some medications the interaction can be dangerous.
Antidepressants are commonly prescribed in the UK and Ireland, and many people who take them like to drink occasionally. But if you or someone in your life is drinking to cope with low mood, alcohol can make your depression harder to treat and put you at greater risk of alcohol dependency.
I contacted Castle Health [formerly CATCH] with a view to getting online support after a period in rehab. They recommended recovery coaching and arranged for me to meet my coach in person as the first of 10 meetings. I continued the coaching on Zoom as I live in France. I was very happy with my 10 sessions and feel I am in a good place to continue my recovery.
What happens when you mix antidepressants and alcohol?
Alcohol is a depressant that slows down the nervous system. Antidepressants work on chemicals linked to depression. When you mix alcohol and antidepressants, the alcohol can stop the medication from working as it should.
The effects of drinking on antidepressants include:
- Feeling more drowsy than usual
- Getting drunk faster on less alcohol
- Low mood getting worse
- Medication becoming less effective at managing your symptoms
The specific risks depend on which type of antidepressant you’re taking. SSRIs and MAOIs each react with alcohol in their own way. If you’re taking a different type, such as an SNRI, a tricyclic, or mirtazapine, alcohol can still increase sedation and reduce how well the medication works. Check with the doctor who prescribed it.
If you’re taking antidepressants and drinking, do not stop your medication so that you can drink. The Royal College of Psychiatrists advises that antidepressants should not usually be stopped suddenly, as this can cause withdrawal symptoms and increase the chance of becoming unwell again.
Speak to your prescribing doctor before making any changes.
Why SSRIs and alcohol don’t mix well
The risk of mixing alcohol and SSRI antidepressants mostly comes down to serotonin. Selective serotonin reuptake inhibitors (SSRIs) are one of the most commonly prescribed types of antidepressant. They work by keeping more serotonin available in the brain.
Research on serotonin and alcohol has shown that alcohol also affects serotonin levels and the receptors that respond to it. When both are present, the combined effect on serotonin can increase drowsiness and make you feel more drunk than you’d expect on the same amount.
A review of reports on SSRI use and alcohol found that some people drank much more after starting an SSRI or a similar antidepressant. If you’ve noticed your drinking increasing since starting an SSRI, that may be connected to the medication itself.
Always talk to your prescribing doctor first.
Why MAOIs and alcohol can be a serious risk
Monoamine oxidase inhibitors (MAOIs) are a less commonly prescribed class of antidepressants. The risk with alcohol is different, but is generally more acute.
Some alcoholic drinks – particularly beer and red wine – contain high levels of a substance called tyramine. Normally, your body breaks this down without any problem. But MAOIs prevent that process from working properly.
If tyramine builds up, it can cause a sudden, dangerous spike in blood pressure. This is called a hypertensive crisis, and it’s a medical emergency. Clinical guidance on MAOIs confirms that MAOIs can trigger a hypertensive crisis if patients consume foods or beverages high in tyramine.
After drinking while taking an MAOI, watch for a sudden severe headache, neck stiffness, chest pain, rapid heartbeat, or confusion. If you or someone near you has any of these, call 112 straight away.
Is any amount of alcohol safe while taking antidepressants?
The safest option is not to drink alcohol with antidepressants at all. Even small amounts of alcohol can reduce the effectiveness of the medication and increase side effects like drowsiness and low mood.
But the answer can depend on your specific medication and your health, so it’s best to talk it through with whoever prescribed it. Don’t skip doses or adjust the timing of your medication around drinking. If you’ve had a drink, don’t drive or use machines, as alcohol and some antidepressants can both make you drowsy.
You can read more about understanding what counts as a safe drinking limit, but antidepressants can make driving dangerous even if you’re under the legal limit.
Is drinking on antidepressants a sign of something more?
When you’re depressed, it’s understandable that you want to feel different, and alcohol can provide quick relief. An antidepressant may take weeks to reach its full effect. While you wait, drinking could become how you manage your mood instead. Once you’ve started drinking this way, it can be hard to notice you now rely on alcohol. If you think this is happening to you, tell your doctor, as they may be able to change your treatment.
You might drink when the medication doesn’t feel like enough, or specifically on bad days. Alcohol may now have become how you get through an evening, rather than something you do occasionally with your friends.
If your drinking and your depression are making each other worse, our page on alcohol and mental health can help you understand both.
“If you drink when you are not one bit thirsty, you may be trying to change the way you feel.”
When to seek help for drinking alongside antidepressants
These signs can mean that drinking alongside antidepressants is starting to harm you.
- Drinking to manage the symptoms your antidepressant is supposed to be treating
- Finding it harder to go without alcohol than you expected
- Drinking more on days when your mood is lowest
- Noticing that alcohol has become part of your routine rather than an occasional choice
- Your medication not helping as much as it used to, despite taking it as prescribed
You might have one or two of these without having an alcohol addiction. If you notice several while combining drinking and antidepressants, tell your doctor. They can check whether alcohol is affecting how well your medication is working.
How to get support for alcohol use and mental health together
If your concern goes beyond an occasional drink, Castle Health can help. Our team addresses depression and alcohol dependency together to prevent one untreated condition from making the other worse.
You can read more about treating addiction alongside mental health conditions.
There’s no referral needed, and you don’t have to have made any decisions. If you’re not sure whether you need treatment for alcohol dependency, a confidential addiction screening can help you get a clearer picture in your own time. Your GP or prescribing doctor can help too, because they know your medication and your history.
If alcohol has become harder to put down
It’s always worth paying attention to. You can find out more about how we support people managing both mental health and alcohol use, whenever you’re ready
Supporting someone who mixes alcohol and antidepressants
If someone in your life is on antidepressants and drinking, you may have noticed things that concern you. Their mood may not be improving despite being on medication, or they may be drinking more than before they started the antidepressant.
These could be signs that alcohol is interfering with their medication, or that drinking has become part of how they’re managing their mental health. Changes like these can have other causes too, so ask them about it before making an assumption.
You don’t need to understand the pharmacology to raise it. You could mention that their medication doesn’t seem to be helping as much, or that they’re drinking more. You could also suggest they ask their GP whether alcohol could be affecting their treatment. Try to pick a time when they’re sober, and you’re both calm.
We can talk through the changes you’ve seen and advise you on what to do. If the person goes on to start treatment, Castle Health’s family support programme offers family therapy alongside their care.
We’ve helped many people turn their lives around
Frequently asked questions about antidepressants and alcohol
Do the same risks apply to mood stabilisers?
Mood stabilisers are a different class of medication with their own interactions with alcohol. The risks of drinking on antidepressants may not apply to them. If you’re taking a mood stabiliser, check with the doctor who prescribed it about whether drinking is safe.
How long should I wait after drinking before taking my antidepressant dose?
There’s no single safe window that applies to everyone. The timing depends on your specific medication and how much you’ve drunk. Don’t skip doses to compensate, and if you’re unsure, your GP can advise.
Can suddenly stopping antidepressants to drink cause problems?
Yes, it can. The Royal College of Psychiatrists advises against stopping antidepressants suddenly. Doing so can cause withdrawal symptoms and increase the risk of becoming unwell. Always discuss changes with your doctor first.
Can you drink on antidepressants? What does UK guidance say?
The NHS advises that drinking alcohol while taking antidepressants can make your symptoms worse, and some types can make you drowsy and dizzy. The NHS also flags interactions with other substances, including cannabis, some painkillers, and St John’s wort.
Where can I find specialist support if I’m worried about mixing medication and alcohol?
Castle Health offers specialist support for people dealing with both, and your GP is a good starting point. You can also take a confidential addiction screening in your own time if you’re not ready to speak to anyone yet.
Where to begin
If you have questions about your own medication and drinking or about someone you know, here are a few ways to follow up.
- Castle Health’s team is available for a confidential conversation about alcohol use and mental health.
- Our confidential screening can help you think it through before speaking to anyone.
- Speak to your GP about how alcohol may be affecting your medication.
