Lexapro and Alcohol

Lexapro is a prescription antidepressant that is used to treat anxiety and depression. It is important to understand how prescription antidepressants interact with alcohol and the risks involved before drinking.
Evidence Based
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What Is Lexapro (Escitalopram)?

Lexapro is the brand name of the drug escitalopram oxalate, an antidepressant medication that is prescribed to treat generalized anxiety disorder (anxiety) and major depressive disorder (depression). Lexapro is a selective serotonin reuptake inhibitor (SSRI) that treats depression by increasing serotonin availability in the brain.

lexapro and alcohol

Side effects of Lexapro include:

  • Nausea
  • Diarrhea
  • 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

Can you Drink Alcohol on Lexapro?

Few studies have been conducted on the interaction between alcohol and antidepressants, so the negative interactions and side effects are not known conclusively. Some studies suggest that light to moderate drinking is safe on some antidepressants, whereas drinking alcohol on other types of antidepressants can cause adverse reactions.

In limited studies of SSRIs like Lexapro, researchers found no serious interactions when consumed with moderate alcohol doses. In another clinical trial, Lexapro did not increase the cognitive and motor effects of drinking alcohol.

The FDA and drug manufacturers do not recommend drinking alcohol while taking Lexapro for lack of definitive evidence of its safety, and with the assumption that antidepressants may enhance the effects of alcohol. 

However, some doctors do allow their patients occasional to moderate drinking while on Lexapro.

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.

Side Effects of Lexapro and Alcohol Interaction

There is limited conclusive data on the side effects of Lexapro and alcohol interaction. Some sources suggest that mixing Lexapro with alcohol may bear some possible adverse short-term effects, including drowsiness, dizziness, increased risk of overdose, and increased feelings of depression or hopelessness.

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. 

Another independent study suggests a possible risk of pathological intoxication when SSRIs such as Lexapro are consumed with alcohol. Pathological intoxication refers to a temporary psychotic episode caused by drinking that is often violent. This condition is most commonly diagnosed in patients with existing mental illnesses. Patients with other diagnosed mental health conditions should speak with their healthcare provider before consuming alcohol with Lexapro.

There are no known consequences associated with long-term use of escitalopram and no known long-term side effects of mixing Lexapro and alcohol.

Dangers of Mixing Lexapro and Alcohol 

Lexapro may increase the sedation and motor effects of alcohol, which may be why some people have reported experiencing blackouts or temporary memory loss after mixing alcohol and Lexapro. 

Drinking while on antidepressants may present a risk for the liver. The National Alliance on Mental Illness suggests that in some patients, when alcohol is combined with antidepressants, the liver cannot process all the toxins present, and fatal toxicity can occur. Studies indicate that drinking while on antidepressants may contribute to liver problems and antidepressant-related hepatic injury. It is currently unknown how Lexapro, in particular, impacts the liver.

Alcohol and Lexapro increase your heart rate, leading to acute severe conditions such as heart failure, especially in patients with high blood pressure. It is 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.

Alcohol, a depressant, can cause or worsen depressive symptoms, which include suicidal thoughts. It also reduces inhibitions, including inhibitions against suicide and self-destructive behavior. 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 illness. 

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.

Lexapro & Alcohol FAQs

Can I have an occasional drink while on Lexapro?

Currently, there is a disagreement between health professionals on whether or not drinking alcohol is safe while on Lexapro based on a lack of conclusive scientific evidence.

In studies of SSRIs and alcohol, the combination of alcohol and SSRIs fails to impair function or produce other effects beyond those of alcohol alone.

Although in experiments with normal subjects, Lexapro has not been shown to increase the mental and motor skill impairments caused by alcohol. The FDA does not recommend that patients consume alcohol while on Lexapro. Most drug manufacturers caution patients against the consumption of alcohol while on antidepressants. 

Some doctors do allow their patients mild to moderate alcohol consumption based on the lack of conclusive evidence of the adverse effects of drinking alcohol while on Lexapro.

You should always discuss with your doctor whether or not it will be safe for you to drink while on Lexapro.

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. However, it is not clear if it is a cause-and-effect relationship.

Patients should also take caution with other prescribed medications. There are potential interactions between any two drugs, including prescription medications. To avoid an adverse reaction, patients should inform their doctor and pharmacist of their medications.

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?

Studies suggest that SSRI antidepressants such as Lexapro do not cause problems when taken with alcohol, and it may be safe for some to drink alcohol in moderation while taking them. 

However, other antidepressants such as monoamine oxidase inhibitors (MAOIs) and Wellbutrin carry serious side effects when combined with alcohol, so drinking alcohol is not recommended for patients taking these types of antidepressants.

Some physicians allow their patients occasional to moderate drinking while on antidepressants. This means 1 drink per day for women and 2 drinks per day for men. However, patients should always speak with their doctor to learn if drinking on antidepressants is safe for them, and should not combine alcohol with an antidepressant until they know how the antidepressant will affect them.


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Resources

Graham, Kathryn, and Agnes Massak. Alcohol Consumption and the Use of Antidepressants. 27 Feb. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC1800314/.

InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: How effective are antidepressants? Updated 18 Jun 2020. https://www.ncbi.nlm.nih.gov/books/NBK361016/

MIT Medical. “FAQ: Antidepressants.” FAQs | MIT Medical, Massachusetts Institute of Technology, 2020, https://medical.mit.edu/faqs/antidepressants

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC5036588/.

National Alliance on Mental Illness. “Can I Drink Alcohol While Taking Antidepressants?” NAMI, National Alliance on Mental Illness, www.nami.org/FAQ/Mental-Health-Medication-FAQ/Can-I-drink-alcohol-while-taking-antidepressants.

National Alliance on Mental Illness. “Escitalopram (Lexapro).” NAMI, National Alliance on Mental Illness, 2016, www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Escitalopram-(Lexapro).

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, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines.

Nestadt, Paul. Why Aren't My Antidepressants Working?, Johns Hopkins Medical, 2020, www.hopkinsmedicine.org/health/wellness-and-prevention/why-arent-my-antidepressants-working.

Pionkowski, J., Wojdyslawska, I., & Patura, E. (1975). Pathological intoxication with alcohol. Psychiatria Polska, 9(2), 161–166. APA Psychnet. American Psychological Association. https://psycnet.apa.org/record/1977-10548-001

Petrow, Steven. “Drinking on Antidepressants.” The New York Times, The New York Times, 20 Dec. 2016, www.nytimes.com/2016/12/20/well/mind/drinking-on-antidepressants.html.

The Pharmaceutical Journal. “Drinking Alcohol during Antidepressant Treatment - a Cause for Concern?” Pharmaceutical Journal, 20 Dec. 2011, www.pharmaceutical-journal.com/news-and-analysis/drinking-alcohol-during-antidepressant-treatment-a-cause-for-concern/11091677.article?firstPass=false.

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC4755252/.

United Kingdom National Health Service. “Alcohol-Related Liver Disease.” NHS.uk, United Kingdom National Health Service, 2018, www.nhs.uk/conditions/alcohol-related-liver-disease-arld/.

United Kingdom National Health Service. “Can I Drink Alcohol If I'm Taking Antidepressants?” NHS.uk, United Kingdom National Health Service, 2019, www.nhs.uk/common-health-questions/medicines/can-i-drink-alcohol-if-i-am-taking-antidepressants/.

U.S. Food and Drug Administration. Lexapro (Escitalopram Oxalate). www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf.

U.S. National Library of Medicine. Escitalopram: MedlinePlus Drug Information. 15 Feb. 2016, https://medlineplus.gov/druginfo/meds/a603005.html

Voican, Cosmin  Sebastian, et al. “Antidepressant-Induced Liver Injury: A Review for Clinicians.” Psychiatry Online, American Journal of Psychiatry, Apr. 2014, https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2013.13050709

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Updated on: September 30, 2020
Author
Addiction Group Staff
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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