Mixing Alcohol & Antidepressants: Cause for Concern?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Aug 28, 2025.

You should usually avoid or limit alcohol use if you're taking an antidepressant. Mixing alcohol and an antidepressant may increase your risk for side effects like dizziness, drowsiness, confusion and trouble concentrating. If you choose to drink, check with your healthcare provider before you combine the two.

When taking an antidepressant you should avoid activities that requiring mental alertness, such as driving or operating hazardous machinery, until you know how the antidepressant affects you. Alcohol use may also worsen your depression, anxiety, mood or behavior. 

Why are antidepressants prescribed?

Antidepressants are a large group of medications used to treat many different health conditions, not just depression. 

Some of the more common conditions treated by antidepressants include:

• Major depressive disorder
• Generalized anxiety disorder
• Seasonal affective disorder
• Social anxiety or social phobias
• Obsessive-compulsive disorder
• Post-traumatic stress disorder (PTSD)
• Eating disorders like bulimia
• Panic attacks
• Diabetic nerve pain
• Muscle and joint pain (like back pain or osteoarthritis)
• Migraine prevention

In general, antidepressants work by altering levels of neurotransmitters in the brain. For mental health disorders, this can have a positive effect on depressed mood and symptoms such as anxiety, insomnia (sleep problems) and suicidal thoughts. Neurotransmitters (brain chemicals) targeted by antidepressants include serotonin, dopamine, gamma-aminobutyric acid (GABA) or norepinephrine.

Types of antidepressants

There are several types (or classes) of antidepressants, but they all work a bit differently. Different classes of antidepressants may exhibit different and unique types of drug interactions, including those with alcohol, so it's important to review each drug you are prescribed.

• Tricyclic antidepressants (TCAs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Monoamine oxidase inhibitors
• Phenylpiperazine antidepressants
• Tetracyclic antidepressants
• Miscellaneous antidepressants

Serious side effect examples

Some drugs used for depression may lead to serious side effects when combined with alcohol. Examples of serious side effects include:

• When antidepressants from the monoamine oxidase inhibitors (MAOIs) class are combined with alcoholic beverages high in tyramine (like beer or red wine), serious heart-related effects such as dangerous high blood pressure can occur.
• Bupropion (Aplenzin, Forfivo XL, Wellbutrin XL), an oral antidepressant or treatment for seasonal affective disorder, should NOT be combined with alcohol due to the risk for seizures.
• Certain antidepressants, such as duloxetine (Cymbalta, Drizalma Sprinkle) may cause liver damage, and taking it with alcohol may increase that risk.
• One study found that mixing alcohol with venlafaxine (Effexor), a serotonin-norepinephrine reuptake inhibitor used to treat depression, anxiety and panic disorder, may lower the threshold for fatal alcohol overdoses.

Always check the warnings and drug interactions in the Patient Information Guide for your antidepressant. You can also ask your pharmacist if you can take your medicine with alcohol if you aren't sure. And never abruptly stop taking an antidepressant unless directed to do so by your doctor, as you may experience uncomfortable or serious side effects and withdrawal symptoms.

Certain dietary supplements like St. John’s wort may have drug interactions as well. St John's Wort is an over-the-counter herbal supplement often used for symptoms of depression. Side effects such as dizziness, drowsiness, and difficulty concentrating can occur when mixed with alcohol. Avoid or limit the use of alcohol while being treated with St. John's Wort.

Liquid medications, such as NyQuil or other cough syrups, may also contain alcohol. Review the ingredient labels on over-the-counter (OTC) products to check for active and inactive ingredients, like alcohol. 

Always check with your healthcare provider or pharmacist for possible drug interactions. Tell them about all of the medications you take, including prescription, over-the-counter (OTC), vitamins and herbal or dietary supplements.

Learn More: Review your medications with the Drugs.com Drug Interaction Checker

Table 1. Common Antidepressants

MAOIs

Monoamine oxidase inhibitors (MAOIs) are an older class of antidepressants typically reserved to treat depression that is not responding to other medications, but they can cause serious interactions. MAOIs are not frequently prescribed, but can be important treatments for patients who fail other treatments for depression.

During and within two weeks after treatment with MAOIs, you must NOT consume any foods or beverages that are high in tyramine content. When MAOIs are combined with alcoholic beverages high in tyramine, serious heart-related effects, such as dangerous high blood pressure (called a hypertensive crisis), may occur. Many foods may be high in tyramine as well, like such as aged cheeses and cured meats.

Alcoholic beverages that are high in tyramine content include:

• red wine
• beer, especially tap or home-brewed
• sherry, vermouth
• liqueurs
• alcohol-free and reduced-alcohol beer can even have small amounts of tyramine

Learn More: MAOIs and diet: Is it necessary to restrict tyramine?

Common Monoamine Oxidase Inhibitors (MAOIs)

*Note: These tables are not complete list of all possible drug interactions with antidepressants. Always check with your pharmacist or other healthcare providerf or possible drug-alcohol interactions. Tell your healthcare providers about all the medications you use including prescription, over-the-counter (OTC) drugs, vitamins, dietary supplements and herbal products.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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