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Updated on September 26, 2022

Lexapro and Alcohol

What Is Lexapro (Escitalopram)?

Lexapro is an antidepressant medication prescribed to treat anxiety and depression. It's a selective serotonin reuptake inhibitor (SSRI), meaning it increases serotonin levels in the brain.

Side effects of Lexapro include:

  • Nausea
  • Constipation
  • Increased sweating
  • Changes in sex drive or ability
  • Drowsiness
  • Dizziness
  • Heartburn
  • Stomach pain
  • Excessive tiredness or trouble sleeping
  • Dry mouth
  • Increased appetite or weight gain
  • Flu-like symptoms
  • Runny nose
  • Sneezing

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Can you Drink Alcohol on Lexapro?

Due to the lack of research on the link between alcohol and antidepressants, negative interactions and side effects are not known conclusively.

Some studies suggest that moderate drinking is safe on some antidepressants, whereas others may experience side effects when combining alcohol and Lexapro.1

Moderate alcohol consumption typically refers to two drinks per day for men and one drink per day for women. One drink is equal to 12 ounces of beer, 5 ounces of wine, or 1 ounce of hard liquor.

These include:

  • Increased feelings of depression
  • Drowsiness
  • Higher risk of overdose
  • Dizziness
  • Decreased efficacy of medications
  • Anxiety

Before combining alcohol with any antidepressant, including Lexapro, patients should discuss the risks with their doctor beforehand to determine if it is safe for them.

Dangers of Mixing Lexapro and Alcohol 

Mixing Lexapro and alcohol can be potentially dangerous, both psychologically and physically.

Psychological Dangers

Lexapro can increase the sedation and motor effects of alcohol. This may be why some report experiencing blackouts or temporary memory loss after mixing alcohol and Lexapro.

According to the FDA, Lexapro may cause drowsiness or affect the ability to make decisions, think clearly, or react quickly. Because alcohol also causes these same symptoms, combining the two drugs may magnify alcohol’s effects. 

Alcohol, a depressant, can cause or worsen depression, which includes suicidal thoughts. Excessive alcohol consumption also reduces inhibitions, including inhibitions against suicidal behavior. It also reduces the effects of antidepressants like Lexapro, contributing to more depressed feelings.

More than half of people who commit suicide are found to have been drinking. This may present an additional risk to patients with substance use disorder or other existing mental health disorders. 

One independent study suggests a possible risk of pathological intoxication when SSRIs such as Lexapro are consumed with alcohol.9 This essentially means temporary insanity and often results in violent behavior.4

Pathological intoxication is most commonly diagnosed in those with with alcohol abuse and existing mental health conditions. People with such conditions should speak with their doctor before consuming alcohol with Lexapro.

Physical Dangers

Drinking while on antidepressants may cause liver damage. Studies indicate that drinking while on antidepressants may contribute to liver problems and antidepressant-related hepatic injury.17

Also, because alcohol decreases the effect of Lexapro to ease depression, most people turn to more alcohol to drown their sadness. This leads to alcohol-induced liver damage.

Alcohol and Lexapro can also increase your heart rate, leading to increase in heart strain and workload. This is true especially in patients with high blood pressure. It's unknown if mixing Lexapro and Alcohol causes long-term heart damage.

It is rare for a patient to overdose on Lexapro alone. But according to the National Institute of Alcohol Abuse and Alcoholism, there is an increased risk for overdose while mixing alcohol and Lexapro.7

Patients with existing health conditions related to the heart, liver, or kidney are at increased risk for side effects. They should discuss whether or not it is safe to drink alcohol while taking Lexapro with their healthcare provider.

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Alcohol Use Disorder

If you or a loved one is having a hard time cutting down on alcohol, it could be a sign of an alcohol use disorder.

If you're wondering if you or someone you know has a drinking problem, you can use this list of symptoms to do a quick self-diagnosis. This is taken from The Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

Remember, a self-assessment is not a substitute for professional medical advice. Alcohol Use Disorder is a medical diagnosis, thus, help from a health care professional is needed.

These are symptoms of an alcohol use disorder, according to the DSM-V:

  • Drinking more or for longer than was intended
  • Unsuccessful attempts to cut down or stop alcohol use
  • Spending a lot of time obtaining, using, or recovering from alcohol consumption
  • Cravings for alcohol
  • Failure to fulfill responsibilities at work, school, or home due to drinking alcohol
  • Continuing to drink despite having social problems caused by the effects of alcohol
  • Important social, work, or recreational activities are stopped or reduced because of alcohol use
  • Drinking in physically dangerous situations
  • Continuing to drink even though it is known to have negative effects on your health
  • Developing a tolerance to alcohol
  • Having withdrawal symptoms after stopping alcohol use

According to the DSM-V:

  • 2 to 3 symptoms is considered mild
  • 4 to 5 symptoms is considered moderate
  • 6 or more symptoms is considered severe

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Luckily, there are many treatment options for anyone suffering from an alcohol addiction, including:

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Lexapro & Alcohol FAQs

Can I have an occasional drink while on Lexapro?

Currently, there is a disagreement between doctors on whether or not drinking alcohol while on Lexapro is safe.

Some do allow their patients moderate alcohol consumption based on the lack of conclusive evidence for any adverse effects.

You should always discuss with your doctor whether or not it will be safe for you to drink while on Lexapro. Furthermore, if you drink alcohol while taking antidepressants, drink slowly and consume the alcohol with food.

What else should I avoid while taking Lexapro?

All illegal drugs should be avoided while taking antidepressant medications because they may worsen depression symptoms and increase sedation. 

Many clinicians believe that marijuana use interferes with the benefits of antidepressant medication. This idea is because there is an association between marijuana use and depression.

Blood thinners should also be avoided during intake of Lexapro. The risk of bleeding increases with the simultaneous use of blood thinners such as NSAIDs, aspirin, and warfarin.

There are potential interactions between any two drugs, including prescription medications. To avoid an adverse reaction, patients should consult their doctor and pharmacist first.

Please note this list is not extensive. Consult your prescriber for further information on what to avoid while taking Lexapro.

Does alcohol make antidepressants less effective?

Alcohol is a depressant known to cause or worsen symptoms of depression including mood changes, making antidepressants less effective.

Is it ever safe to drink alcohol while taking antidepressants?

There are conflicting results of studies on the safety of alcohol use together with Lexapro.

Other antidepressants such as monoamine oxidase inhibitors (MAOIs) and Wellbutrin carry serious side effects when combined with alcohol. Drinking alcohol while taking these types of antidepressants is not recommended.

Some physicians allow their patients occasional to moderate drinking while on antidepressants. However, patients should speak with their doctor first before drinking while on any medication.

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Resources

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  1. Graham, Kathryn, and Agnes Massak. "Alcohol Consumption and the Use of Antidepressants." 27 Feb. 2007.
  2. InformedHealth.org. Cologne, Germany. "How effective are antidepressants?" Updated 18 Jun 2020.
  3. MIT Medical. “FAQ: Antidepressants.” FAQs | MIT Medical, Massachusetts Institute of Technology, 2020.
  4. Lu, Da-Li, and Xiao-Ling Lin. “Development of Psychotic Symptoms Following Ingestion of Small Quantities of Alcohol.” Neuropsychiatric Disease and Treatment, U.S. National Library of Medicine, 22 Sept. 2016.
  5. National Alliance on Mental Illness. “Can I Drink Alcohol While Taking Antidepressants?” NAMI, National Alliance on Mental Illness.
  6. National Alliance on Mental Illness. “Escitalopram (Lexapro).” NAMI, National Alliance on Mental Illness, 2016.
  7. National Institute on Alcohol Abuse and Alcoholism. “Harmful Interactions.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, June 2003.
  8. Nestadt, Paul. "Why Aren't My Antidepressants Working?" Johns Hopkins Medical, 2020.
  9. Pionkowski, J., Wojdyslawska, I., & Patura, E. . "Pathological intoxication with alcohol." Psychiatria Polska, 9, 161–166. APA Psychnet. American Psychological Association.
  10. Petrow, Steven. “Drinking on Antidepressants.” The New York Times, The New York Times, 20 Dec. 2016.
  11. The Pharmaceutical Journal. “Drinking Alcohol during Antidepressant Treatment - a Cause for Concern?” Pharmaceutical Journal, 20 Dec. 2011.
  12. Razavi Ratki, Seyed  Kazem, et al. “Can Antidepressant Drug Impact on Blood Pressure Level in Patients with Psychiatric Disorder and Hypertension? A Randomized Trial.” International Journal of Preventive Medicine, U.S. National Library of Medicine, 26 July 2016.
  13. United Kingdom National Health Service. “Alcohol-Related Liver Disease.” NHS.uk, United Kingdom National Health Service, 2018.
  14. United Kingdom National Health Service. “Can I Drink Alcohol If I'm Taking Antidepressants?” NHS.uk, United Kingdom National Health Service, 2019.
  15. U.S. Food and Drug Administration. "Lexapro (Escitalopram Oxalate)."
  16. U.S. National Library of Medicine. "Escitalopram: MedlinePlus Drug Information." 15 Feb. 2016.
  17. Voican, Cosmin  Sebastian, et al. “Antidepressant-Induced Liver Injury: A Review for Clinicians.” Psychiatry Online, American Journal of Psychiatry, Apr. 2014.

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