Antipsychotic Medications and Alcohol Interactions
Antipsychotics are a large class of medications used to treat symptoms of psychosis such as delusions (for example, hearing voices), hallucinations, paranoia, or confused thoughts. They are used for other mental health disorders as well. They work by changing the balances of chemicals in the brain. Some of the most common uses for antipsychotic are:
Older antipsychotics are called first generation antipsychotics (or typical antipsychotics), and antipsychotics that have been developed more recently are called second generation antipsychotics (or atypical antipsychotics).
Second generation antipsychotics are less likely to produce movement disorders such as tremor, Parkinson's-like symptoms and tardive dyskinesia, a serious movement disorder with abnormal, repetitive facial movements and tongue protrusion.
Check drug interactions here: Drugs.com Drug Interaction Checker
Antipsychotics have central nervous system (CNS) depressive properties and should not be used in combination with alcohol (ethanol) due to enhanced side effects of one or both drugs. In addition, the phenothiazines (first generation) should not be used in patients with acute alcohol intoxication or undergoing alcohol withdrawal due to elevated seizure risk. Patients who have pre-existing liver disease, such as alcoholic cirrhosis, may not be able to use some antipsychotics.
The combination of second generation antipsychotics and alcohol can cause the following side effects:
- dizziness
- drowsiness or sedation
- difficulty concentrating
- impairment with thinking or judgement
If you combine alcohol with the older first generation antipsychotics, the side effects can be more pronounced. The following reactions may occur:
- dizziness
- drowsiness, sedation or coma
- respiratory depression
- poor decision making
- slowed thinking
- low blood pressure (hypotension)
- a change in body temperature
- fainting
- a change in heart rate
- hazards when driving, operating machinery or engaging in risk activities
- agitation
- seizures
- increased risk for suicide
- uncontrollable movements disorders
- an increased risk for a fall and injury.
Learn More: What is Schizophrenia?
Types of Antipsychotics
- atypical antipsychotics
- miscellaneous antipsychotic agents
- phenothiazine antipsychotics
- thioxanthenes
Avoid driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until you know how these or other medications affect you.
To learn more about individual antipsychotic drug interactions with alcohol, select the Interactions tab on each monograph below and speak to your doctor and pharmacist.
Table 1. Second Generation Antipsychotics
| Generic Name | Example Brand Names |
|---|---|
| aripiprazole, aripiprazole lauroxil | Abilify, Abilify Maintena, Aristada |
| brexpiprazole | Rexulti |
| cariprazine | Vraylar |
| clozapine | Clozaril, Fazaclo |
| iloperidone | Fanapt |
| lumateperone | Caplyta |
| lurasidone | Latuda |
| olanzapine | Zyprexa, Zyprexa Zydis |
| olanzapine and samidorphan | Lybalvi |
| paliperidone | Invega |
| pimavanserin | Nuplazid |
| quetiapine | Seroquel, Seroquel XR |
| risperidone | Risperdal, Risperdal M-Tab |
| ziprasidone | Geodon |
Lybalvi (olanzapine and samidorphan) was approved in May 2021 and is a combination of olanzapine and samidorphan, a novel μ-opioid receptor antagonist for the treatment of schizophrenia and bipolar I disorder.
Table 2. First Generation Antipsychotics
| Generic Name | Example Brand Names |
|---|---|
| chlorpromazine | none available |
| fluphenazine | none available |
| haloperidol | Haldol |
| loxapine | Adasuve |
| perphenazine | none available |
| pimozide | none available |
| prochlorperazine | Compro suppositories |
| thioridazine | none available |
| thiothixene | Navane |
| trifluoperazine | none available |
*Note: These tables may not be a complete list; always check with your pharmacist or doctor for possible drug-alcohol interactions or other 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
- ADHD Medications and Alcohol
- Allergies, Cough/Cold Medications and Alcohol
- Antibiotic Medications and Alcohol
- Antidepressant Medications and Alcohol Interactions
- Anxiety Medications and Alcohol
- Bipolar Medications and Alcohol
- Birth Control Pills and Alcohol
- Blood Thinners and Alcohol: A Dangerous Mix?
- Caffeine, Energy Drinks and Alcohol
- Can You Mix Weight Loss Drugs and Alcohol?
- Cholesterol Medications and Alcohol
- Diabetes Medications and Alcohol
- Enlarged Prostate (BPH) Medications and Alcohol Interactions
- Erectile Dysfunction Medications and Alcohol
- Heart Medications and Alcohol
- Herbal Supplements and Alcohol
- Illicit Drugs and Alcohol Interactions
- Is it safe to drink alcohol with acne medicines?
- Motion Sickness Drugs and Alcohol Interactions
- Pain / Fever Drugs and Alcohol Interactions
- Seizure Medications and Alcohol Interactions
- Should you mix muscle relaxants with alcohol?
- Stomach / Heartburn Medications and Alcohol
- What are the dangers of mixing sleeping pills with alcohol?
Sources
- Freed E Alcohol-triggered-neuroleptic-induced tremor, rigidity and dystonia. Med J Aust 2 (1981): 44-5.
- Product Information. Seroquel (quetiapine). Zeneca Pharmaceuticals, Wilmington, DE. Accessed Feb. 24, 2022.
- Lutz EG Neuroleptic-induced akathisia and dystonia triggered by alcohol. JAMA 236 (1976): 2422-3.
- Product Information. Perphenazine. Sandoz. Princeton, NJ. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/089683s024lbl.pdf
- Product Information. Nuplazid. Acadia Pharmaceuticals. San Diego. https://www.nuplazid.com/sites/nuplazid/files/pdf/NUPLAZID_Prescribing_Information.pdf
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
