Whether you can drink on antidepressants is a commonly asked question, but there’s no single definitive answer. It depends on the type of antidepressant you’re taking, how much you drink, how often, and what else you’re taking. Some combinations are riskier than others.
Millions of people in the UK take antidepressants, and some still drink socially. But the dangers of mixing antidepressants and alcohol aren’t only due to chemistry. If you’re already drinking to cope with how you feel, it can end up making that depression or anxiety worse, separate from how the substances interact.
Understanding the risks of mixing antidepressants and alcohol, and how drinking can affect conditions like depression, can help you decide whether to take a break from alcohol.
Find out how we approach dual diagnosis treatment
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Can you drink alcohol on antidepressants?
As a general rule, drinking alcohol while taking antidepressants isn’t recommended at all. While every drink may not be dangerous, alcohol can negatively impact the benefits that antidepressants have in the brain.
This differs by antidepressant type, and risk also depends heavily on how much and how often you drink. But as general advice, drinking on antidepressants is rarely a good idea.
How alcohol interacts with antidepressants, and why it varies
The relationship between antidepressants and alcohol is rarely straightforward. Alcohol is a depressant and slows down your central nervous system. This can affect:
- Judgement
- Coordination
- Mood
- Reaction time
Antidepressants work in the opposite direction, gradually adjusting brain chemistry to lift mood. When you drink, you’re pulling against the thing your medication is trying to do.
The exact risk depends on which antidepressant you’re taking. Different types affect different chemical pathways, and alcohol interferes with each of them differently.
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Drinking on antidepressants by type
SSRIs are generally considered the lowest risk of the main types, and low levels of alcohol are often thought to be relatively safe alongside them. This isn’t risk-free, though. A review of over 200 case reports found that reaction called ‘pathological intoxication’ occurred in around half of the cases.
SNRIs, including venlafaxine: one study found that combining alcohol with venlafaxine may lower the amount of alcohol needed to cause a fatal overdose.
Tricyclic antidepressants (TCAs): these older medications that tend to be more sedating on their own. Alcohol then adds to that. The combination often causes a stronger, more exaggerated version of drunkenness than either would alone, along with a greater risk of drowsiness and poor coordination.
MAOIs may carry the most risk. Certain foods and drinks – including some beers and wines – contain a substance called tyramine. In people taking an MAOI, tyramine can cause a sudden, dangerous spike in blood pressure. Because of this, MAOIs are prescribed far less often today.
Bupropion is also sometimes prescribed as an antidepressant. One study found it may lower the threshold for seizures, and alcohol can raise that risk further.
Why alcohol and depression so often go together
The link between drink and antidepressants isn’t as simple as the mixing of chemicals. Some people drink to cope with low mood. But research shows that alcohol tends to make depression worse in the long run.
Alcohol Change UK notes that people drinking at hazardous or harmful levels report depression and anxiety at far higher rates than people who don’t drink.
If you’re on antidepressants and you’re also drinking more than you’d like to, that could be a warning sign. Alcohol can become a way of managing feelings that antidepressants aren’t managing, and that reliance is a big part of addiction.
“During my stay at Castle Craig I was made to feel accepted and safe. It is a beautiful place with very caring staff. For me it was a life changing experience. And helped me so much. I’m looking forward to the future one step at a time.”
Signs that alcohol and antidepressants have become a concern
There are common patterns to look for in yourself or someone else.
- Drinking more, or more often, since starting antidepressants
- Drinking specifically to manage low mood or anxiety
- Feeling like your medication isn’t working as well as it used to
- Needing more alcohol to get the same effect, or feeling unable to cut down
None of these confirm a problem on their own, but together, they should be taken seriously.
How to get help, alcohol, antidepressants, and dual diagnosis
If any of this feels familiar, a good first step is speaking to your GP. They can review your medication and talk through what you’re experiencing with alcohol.
When alcohol use and a mental health condition like depression co-exist, it’s called dual diagnosis.
At Castle Craig, treatment addresses both conditions together. Our support covers both alcohol dependency and, where relevant, prescription drug addiction, alongside the underlying mental health condition.
Addiction and mental health
Find out more about our expert, medically-led, dual-diagnosis approach to addiction treatment
If someone in your life is drinking while on antidepressants
Watching someone you care about drink while they’re on antidepressants can be frightening. Not knowing what to do, or worrying you’ll make things worse by saying something can leave you feeling stuck.
From the outside, you might notice them drinking more, or seeming stuck in a low mood for longer than before. You don’t need to have the right words or a full understanding of dual diagnosis to start a conversation. Often, simply saying what you’ve noticed, without judgement, is enough to open the door to further dialogue.
If you don’t know how to approach them, seeking help doesn’t have to start with the person drinking. Castle Craig can provide support and advice about what to say.
Frequently asked questions about if you can drink on antidepressants
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Which antidepressants have the least interaction with alcohol?
SSRIs are generally considered to carry the lowest risk of the main antidepressant types, and low levels of alcohol are often thought to be relatively safe alongside them. But lowest risk isn’t the same as risk-free, and you should always check with your prescriber.
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Can I skip a dose of my antidepressant to drink?
No. Skipping a dose to drink can bring on withdrawal-like symptoms and destabilise your mood, and starting and stopping antidepressants around drinking can make your underlying depression harder to treat. If you’re finding yourself doing this regularly, speak to your GP or prescriber.
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Are there alcohol-free alternatives recommended for people on antidepressants?
There’s no single recommended brand, but alcohol-free beer, wine, and spirits are easy to find in UK shops and pubs. Many people on antidepressants drink them so they can still enjoy a night out, without the risk.
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Where can I find UK pharmacies that provide advice on this?
Any UK pharmacy can advise on interactions between alcohol and your specific antidepressant. Most offer a private consultation area, and you don’t need an appointment.
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How much alcohol can you drink while on antidepressants?
This varies a lot from person to person, and depends on which antidepressant you’re taking and how your body responds to it. Because of this, it’s best to ask your prescriber directly.
