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Antidepressants & Alcohol: The Effects & Risks

Why You Should Never Mix Alcohol and Antidepressants

Antidepressants and alcohol never go together well. Depression is a common driver of addiction. Learn more about antidepressants and alcohol here.

Depression affects millions worldwide and is one of the most prevalent mental health issues. Unfortunately, some people may be utterly ignorant that they are depressed, while others mistakenly believe that occasionally feeling melancholy is a sign of depression.

Anxiety, meanwhile, is another prevalent mental health condition. People diagnosed with either of these disorders have generally been prescribed antidepressants

Antidepressants function by raising some naturally-occurring neurotransmitters in our body and brain. These chemicals control many things- how you feel, react, and even your decision-making abilities. 

By the Numbers:

According to a study conducted by the Canadian Medical Association Journal [CMAJ], depressed individuals are more likely to suffer from alcohol use disorders than non-depressed people.

Healthcare professionals often advise patients not to consume alcohol or alcoholic beverages when taking prescription-based anti-depressants. Alcohol has the tendency to make you feel gloomy, which means that it has the potential to trigger depressive thoughts. Apart from the psychological side effects, the combination of alcohol and anti-depressants can cause some physical harm to the user. 

Let us learn more about antidepressants and why avoiding drinking is in your best interests when using them as part of your treatment plan. 

What Are Antidepressants?

Antidepressants are a classification of medically prescribed drugs used to treat mental health problems and patients dealing with clinical depression. Additionally, antidepressants are also used to reduce the symptoms of OCD, anxiety, personality disorder, and more. However, it has been noticed that antidepressants can have serious side effects and interactions with other substances.

So, asking your doctor and physician before mixing any substance while taking anti-depressant medication is always better.

Antidepressants were first introduced in the 1950s, and since then, it has seen continuous growth in the market. They can be classified under :

  • SSRIs or Serotonin Reuptake Inhibitors

  • SNRIs or Serotonin-Norepinephrine Reuptake Inhibitors

  • SARIs or Serotonin Antagonists and Reuptake Inhibitors

  • SMSs or Serotonin Modulators and Stimulators

Types of Antidepressants

The two most prominent forms of anti-depressant medication prescriptions are SSRIs and SNRIs.

Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are generally the first line of medication given to patients dealing with depression ranging from moderate to severe. By blocking the reabsorption of serotonin by the brain neurons, it can reduce the severity of symptoms. Some of the medications that come under this classification are Prozac, Zoloft, Paxil, Celexa, etc. 

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Like SSRIs, SNRIs also block serotonin by blocking the reabsorption of norepinephrine. It affects both neurotransmitters and stabilizes the mood and stress of the user. It is generally given to patients dealing with anxiety and ADHD. Some medications in this include Effexor, Pristiq, Milnacipran, etc. 

Serotonin Antagonists and Reuptake Inhibitors (SARIs)

SARIs are mainly used to treat patients with insomnia and anxiety. They are more similar to sedatives, and they inhibit the 5HT2a serotonin receptor. Here, the medication includes Nefazodone and Trazodone. 

Serotonin Modulators and Stimulators (SMSs)

SMSs are atypical anti-depressants and include prescriptions like Vortioxetine and Vilazodone. Their role is to regulate and inhibit serotonin reuptake. 

TCAs

TCAs, often known as tricyclic/tetracyclic anti-depressants, prevent serotonin and norepinephrine from being reabsorbed. In contrast to other forms of anti-depressants, they also have the unintended consequence of preventing the resorption of many other substances, which results in several side effects.

MAOIs

Monoamine oxidase inhibitors, or MAOIs, are a family of anti-depressants primarily prescribed to people who have not noticed major benefits from other anti-depressants. Since they are high-strength anti-depressants, MAOIs can have serious side effects. Although MAOIs are rarely administered, they can be crucial medications for people whose other attempts at treating their depression have failed. You must abstain from eating any tyramine-rich foods or beverages while taking MAOIs and for two weeks afterward.

Alcoholic beverages with a high tyramine content mixed with MAOIs may have substantial side effects on the patient’s heart health, such as high blood pressure. Several foods, like cheeses and cured meats, may also have high levels of tyramine. The types of alcohols that are known to have particularly increased concentrations of tyramine are: 

  • Tap beer

  • Sherry 

  • Liqueurs

  • Vermouth

  • Red wine

Small quantities of tyramine can be found even in alcohol-free beer

Alcohol And Depression

Alcohol, by its nature and composition, falls into the category of depressant drugs. For this particular reason, it has the potential to worsen your depression. Some people use alcohol as a means to cope with mental health issues. However, such people do not realize they are being roped into a malicious cycle: you feel sad, drink, and drink because you feel sad. By using alcohol as their coping mechanism, they are feeding their depression. 

The cycle gets even more harmful when you throw antidepressants into the mix. People who continue their binge drinking habits even when taking antidepressants are not just nullifying the effects of the medication. Still, due to the formation of this toxic combination, their body is also actively harming themselves. 

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Why Antidepressants and Alcohol Should Not Be Mixed

Let us now learn why it is imperative to maintain sobriety while taking anti-depressants.

Antidepressants can be prescribed for several mental health conditions, not just for managing depression. This is mainly because mental illnesses can be interrelated and treated with the same medications. For example, some people say that they consume alcohol because it calms down their jitters and anxious thoughts.

However, while it is true that alcohol consumption can stifle anxiety, it can also worsen the symptoms of other mental disorders. Therefore, when prescribed anti-depressants for any illness, you must stop alcohol consumption. 

Furthermore, consuming alcohol or alcoholic beverages while taking anti-depressants can heighten your chances of facing their side effects, such as:

  • Weariness/fatigue 

  • Diarrhea

  • Vomiting/unsettled stomach

  • Queasiness

  • Weight gain

  • Sexual dysfunction

Combining alcohol and antidepressants can also influence decision-making abilities, coordination, reaction time, and basic motor skills. But, overall, they weaken your ability to do tasks requiring focus and attention. 

Why alcohol and antidepressants are dangerous together

Side Effects of Different Anti-Depressants When Mixed with Alcohol

SSRIs

Some doctors consider it safe for people to drink in moderation while taking SSRIs. However, results may vary depending on the person’s medical history, genes, drinking habits, etc. 

  • Examples of SSRIs: Zoloft, Paxil, Prozac, Lexapro, and Celexa 

SNRIs

SNRIs are mostly prescribed to alleviate symptoms of anxiety and ADHD and can prove very harmful if taken with alcohol. Some studies have also shown that when consumed along with alcohol, SNRIs can cause or worsen liver dysfunctions. 

  • Examples of SNRIs: Pristiq, Ultram, Effexor XR, Cymbalta, and Strattera

TCAs

Tetracyclic or tricyclic anti-depressants are considered safe when combined with alcohol, but only in small quantities. Overindulgence in alcohol can worsen depressive episodes. 

  • Examples of TCAs: Anafranil, Norpramin, Tofranil, Surmontil and Elavil

MAOIs

According to healthcare professionals, MAOIs should never be mixed with alcohol as they have some severely risky side effects. For example, tyramine present in some foods and alcohol, when mixed with MAOIs, can increase your blood pressure to the point that you would require immediate medical attention. 

  • Examples of MAOIs: Parnate, Zelapar, Azilect, Marplan, and Eldepryl

Alcohol Use Disorders and Anti-Depressants

Unfortunately, people can experience multiple mental health issues at a time. Often, a mental health condition can co-occur with a substance use disorder such as alcoholism. This is known as a dual diagnosis. In some cases, people get addicted to alcohol mostly because they are trying to relieve the symptoms of their depression or anxiety. And in other situations, people develop mental health issues because they abuse alcohol or other drugs regularly.

Whatever the case, each disorder worsens the effects of the other. Therefore, it is wise to talk to your doctor about your history of alcoholism or alcohol use disorder before being prescribed anti-depressants. 

You may think that you will be able to control your drinking for the sake of being able to treat your depression or other mental health conditions. However, that is not true of everyone. Some people develop a dependency on alcohol and cannot stop themselves from binge drinking or getting high every day.

Even quitting alcohol all of a sudden will prove risky for such people. Quitting "cold turkey" can cause severe withdrawal symptoms and would worsen your mental well-being. It is always advisable to contact a medical professional in such situations. They can help you quit alcohol before prescribing anti-depressants. 

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Can I Skip a Dose of My Anti-Depressant to Drink Alcohol?

Like most medications, anti-depressants require consistency. You can only fight depression when you take your meds, as advised by your doctor. And, no doctor would allow you to skip a dose of your medication to drink alcohol. 

It is understandable that to some people skipping a dose of anti-depressants every once in a while may not look like such a bad idea. But, according to some studies, doing so can have a massive effect on your mental health as your depressive symptoms can reappear.  

Some medications, when skipped for one day, can cause withdrawal symptoms or anti-depressant discontinuation syndrome. Some of those symptoms are:

  • Lethargy

  • Irritability

  • Migraines

  • Excessive sweats

  • Restlessness

  • Disrupted sleep cycle 

  • Aggressive behavior

  • Mood swings 

  • Anxiousness

  • Vertigo

  • Shakes/dizziness 

  • Nausea 

When paired with alcohol or alcoholic beverages, these anti-depressant withdrawal symptoms could only become worse. If you are unsure about and want to take a day off from taking anti-depressants for drinking alcohol, please talk to your healthcare provider. 

How to Get Treatment for Your Drinking Problem

Accepting that you have a problem with drinking can be daunting. And getting the required help and support to treat that problem can be even more frightening. However, the one thing that you need to remember is that you are not alone. Most people resist the idea of treatment at first. Recovery from alcoholism or alcohol use disorders is not just about treating disease. It is about making a significant life change, and social scientists observe common patterns in making such changes.

Someone who manages to stay unaware of a problem can easily deny that there is a problem. Therefore, attempting to recover and choose an alcoholism treatment can be one of the most critical steps you take in your life. It will make you eligible to consume prescription anti-depressants and improve your life as a whole. 

Everyone, who deals with a condition where they cannot even begin to treat their depression because of their drinking issues, has to step up and see the importance of recovery centers. These centers are designed to help people suffering from dependence on alcohol and other drugs. If you try to treat yourself by quitting alcohol abruptly, you are likely to experience the uncomfortable and, in some cases, severe withdrawal effects.

Seeking rehab help to manage the conditions is always better. They will help in three ways:

  • Medical Detox: In some cases, the patients need to have excess alcohol medically removed from their bodies. The process is known as drug detox. 

  • Rehabilitation: If the condition is severe and the addiction signs are strong, the patient must opt for rehab, where they will go through a comprehensive treatment program. Inpatient drug rehab and outpatient drug rehab can help people leave alcohol abuse behind.

  • Therapy: Cognitive-behavioral therapy (CBT) and Dialectical Behavior Therapy (DBT) has proven to be very helpful in treating alcohol dependence.

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If you or a loved one is struggling with addiction, there is hope. Our team can guide you on your journey to recovery. Call us today.

Written by

brian-mooreBrian Moore

Content Writer

Reviewed by

jeremy-arztJeremy Arzt

Chief Clinical Officer

Drug and Alcohol

Addiction Recovery

Sobriety

March 8, 2023