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Antidepressants and Alcohol Interactions

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on May 28, 2024.

You should usually avoid or limit alcohol use if you're taking an antidepressant. Depression medicines mixed with alcohol may increase central nervous system (CNS) side effects, like dizziness, drowsiness, confusion and trouble concentrating. Check with your healthcare provider before you mix the two.

When taking an antidepressant you should avoid activities that requiring mental alertness, such as driving or operating hazardous machinery, until you know how the antidepressant affects you. Alcohol use may also worsen your depression, anxiety, mood or behavior.

Why are antidepressants prescribed?

Antidepressants are a large group of medications used to treat many different health conditions. Not all of these conditions are mental health conditions.

Some of the more common conditions treated by antidepressants include:

Antidepressants work by altering levels of neurotransmitters in the brain to cause an enhanced effect on depressed mood and symptoms such as anxiety, insomnia (sleep problems), and suicidal thoughts. Neurotransmitters (brain chemicals) targeted by antidepressants include serotonin, dopamine, gamma-aminobutyric acid (GABA) or norepinephrine.

Types of antidepressants

There are several types (classes) of antidepressants, but they all work a bit differently. Different classes of antidepressants may exhibit different and unique types of drug interactions, including those with alcohol, so it's important to review each drug you are prescribed.

Serious side effect examples

Some drugs used for depression may lead to serious side effects when combined with alcohol. Examples of serious side effects include:

Always check the warnings and interactions in the labeling for your antidepressant. You can always ask your pharmacist if you can take your medicine with alcohol if you aren't sure. And never abruptly stop taking an antidepressant unless directed to do so by your doctor, as you may experience uncomfortable or serious withdrawal symptoms.

Certain dietary supplements like St. John’s wort, an over-the-counter herbal supplement often used for symptoms of depression, may have drug interactions as well. Side effects such as dizziness, drowsiness, and difficulty concentrating can occur when mixed with alcohol. Avoid or limit the use of alcohol while being treated with St. John's Wort.

Liquid medications, such as NyQuil or other cough syrups, may also contain alcohol. Review the ingredient labels on over-the-counter (OTC) products to check for active and inactive ingredients, like alcohol. 

Always check with your healthcare provider or pharmacist for possible drug interactions.

Learn More: Review your medications with the Drugs.com Drug Interaction Checker

Table 1. Common Antidepressants

Generic Name Brand Name
aripiprazole Abilify
amitriptyline Not available
brexanolone Zulresso
bupropion Aplenzin, Forfivo XL, Wellbutrin XL, Wellbutrin SR
citalopram Celexa
clomipramine Anafranil
desipramine Norpramin
desvenlafaxine Pristiq
duloxetine Cymbalta
escitalopram Lexapro
esketamine Spravato
fluoxetine Prozac
fluvoxamine Luvox
levomilnacipran Fetzima
mirtazapine Remeron, Remeron SolTab
nefazodone Not available
paroxetine Paxil
risperidone Risperdal
sertraline Zoloft
St. John’s wort Dietary Supplement / Herbal Product
trazodone Not available
venlafaxine Effexor, Effexor XR
vilazodone Viibryd
vortioxetine Trintellix
Rexulti (brexpiprazole) is an antipsychotic medication but is used together with other medicines to treat major depressive disorder in adults.

MAOIs

Monoamine oxidase inhibitors (MAOIs) are a class of antidepressants typically reserved to treat depression that is not responding to other medications, but they can cause serious interactions. MAOIs are not frequently prescribed, but can be important treatments for patients who fail other treatments for depression.

During and within two weeks after treatment with MAOIs, you must NOT consume any foods or beverages that are high in tyramine content. When MAOIs are combined with alcoholic beverages high in tyramine, serious heart-related effects, such as dangerous high blood pressure (called a hypertensive crisis), may occur. Many foods may be high in tyramine as well, like such as aged cheeses and cured meats.

Alcoholic beverages that are high in tyramine content include:

Learn More: MAOIs and diet: Is it necessary to restrict tyramine?

Common Monoamine Oxidase Inhibitors (MAOIs)

Generic Name Brand Name
isocarboxazid Marplan
phenelzine Nardil
tranylcypromine Parnate
selegiline Emsam

*Note: These tables may not be complete lists; always check with your pharmacist for possible drug-alcohol interactions. Tell your healthcare providers about all the other medications you use including prescription, over-the-counter (OTC) drugs, vitamins, dietary supplements and herbal products.

Types of Drug Interactions With Alcohol

Sources

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer