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Antidepressants are medications prescribed to treat depression. There are different types and each come with various side effects.
Antidepressant medications can negatively interact with alcohol. Drinking while on them puts your at higher risk for serious side effects.1
There are five major classes of antidepressants. Each takes a different approach to treating symptoms of depression and has different side effects. The five classes are:
SSRIs are the most popular class of antidepressants.
They increase serotonin levels in the brain by stopping nerve cells from re-absorbing it, keeping it in there longer. Serotonin is a chemical in your brain responsible for feelings of well-being. Common SSRI brands include Lexapro, Zoloft, and Prozac.
These block reuptake of sertonin and norepinephrine.
Norepineprhine is a brain chemical responsible for focus and memory. Popular SNRI brands include Cymbalta, Effexor, Pristiq, and Paxil.
These are an older class of antidepressants that have been in use since the 1950s. Similar to SNRIs, they increase serotonin and norepinephrine levels in the brain. They have more side effects than newer medications and are less common today.
Some notable TCA brand names include Anafranil and Norpramin.
MAOIs are the oldest class of antidepressants.
They have mostly been discontinued due to unpleasant side effects, such as hypertension, and interactions with alcohol and other drugs. MAOIs increase serotonin, norepinephrine, and dopamine levels in the brain. Brands include Nardil, Marplam, and Emsam.
These medications do not fit into any particular class of antidepressants. Because of this, the mechanisms of action and possible side effects all differ. Some brands include Bupropion (Wellbutrin), Trazodone, and Mirtazapine.
The side effects of antidepressants depend on the class of antidepressant and your specific biology.
Other common side effects of SSRIs include:
Some more serious side effects in rare cases include:
SSRIs may actually raise the risk of suicidal thoughts and behaviors, at least at first. Since they ease but don't eliminate depressive symptoms, patients may feel "in control" just enough to take their lives.
For some, this could include taking their own lives. Patients should be closely watched by loved ones and healthcare providers during the first few weeks of treatment.
Side effects of MAOIs include headaches and insomnia. In rare cases, eating certain foods while taking them can cause hypertension and cerebral hemorrhage.
An early MAOI, Iproniazid, was discontinued due to it being linked to acute liver failure.11
Common side effects of TCAs include unwanted weight gain, sedation, sexual dysfunction, and risk of suicidal thoughts.
The side effects of atypical antidepressants can vary. For example:
Alcohol affects your body's ability metabolism. This makes getting the dosage of medications right more complicated.
There are two ways that alcohol alters the body’s ability to metabolize certain antidepressants:
Different people metabolize alcohol and medications in various ways. Because of this, it is hard to assess the risk of a bad interaction in a particular person.
Alcohol consumption while taking antidepressants can lead to various negative side effects. Antidepressants can strengthen the effects of alcohol, increasing impairment.
For example, some antidepressants have sedative effects, which can combine when taken with alcohol. Combining alcohol with MAOIs, can lead to high blood pressure.
Additional side effects include greater risk of impulsive and violent behavior.
Drinking alcohol can undermine treatment for depression since alcohol is a depressant.
People with alcohol use disorder are often have other co-occurring mental health conditions. If you have problems with alcohol and mental health, it is essential to seek help.
Evidence suggests that even moderate drinking can interfere with the production of serotonin. Heavy drinking is linked to a higher risk for mood disorders. Alcohol dependence can also induce feelings of guilt and low self-worth, worsening symptoms of depression.
Evidence shows some people have a lower tolerance for alcohol while taking antidepressants.5
Consequences for drinking while taking them include impaired memory and impulsive behavior.
This can lead to a blackout. A blackout is when your memory is so impaired that you may not remember what you did the night before.
Mixing alcohol and depression medication can cause difficulty breathing, heart problems, and internal bleeding.
One study found combining SSRIs with alcohol raises the risk for Rhabdomyolysis, a life-threatening condition.10
If you drink alcohol while taking MAOIs, you may increase your risk for dangerously high blood pressure.
And while it may produce euphoria in the moment, alcohol makes depression worse in the long run. It can also lower inhibitions, which may lead to an increased risk for suicide.
According to a national survey, 16.9% of the 20.3 million people who suffered depression also reported substance use disorder (SUD).1 The bulk of those said alcohol was their drug of choice.1
Another survey found those that abuse alcohol are 3.7 times more likely to have depression.7
People who mix alcohol with antidepressants may therefore be at greater risk of alcohol use disorder.
Some symptoms of alcohol use disorder include:
Treatment options break down into three principal approaches:
Limited research indicates the third approach is the most effective in many situations.
One possible technique, a motivational intervention, involves respectfully confronting the patient.
The patient is made to understand the importance of being accountable for themselves.
All approaches can take place in both one-on-one settings and within a larger support group.
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