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Antidepressants and Alcohol Interactions

Written by L. Anderson, PharmD on Nov 7, 2017

Antidepressants are a large group of medications used to treat many different mental health conditions. Some of the more common conditions antidepressants are used to treat include:

Antidepressants work by altering levels of neurotransmitters in the brain to cause an enhanced effect on depressed mood and symptoms such as anxiety, insomnia (sleep problems), and suicidal thoughts. Neurotransmitters targeted by antidepressants include serotonin, dopamine, or norepinephrine.

In general, depression medication and alcohol may increase central nervous system (CNS) side effects such as:

  • Dizziness
  • Drowsiness
  • Confusion
  • Difficulty concentrating

Avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Certain antidepressants, such as duloxetine (Cymbalta) may also cause liver damage, and taking it with alcohol may increase that risk.

There are six classes of antidepressants, including:

  • Tricyclic antidepressants
  • Selective serotonin reuptake inhibitors
  • Serotonin and norepinephrine reuptake inhibitors
  • Norepinephrine and dopamine reuptake inhibitors
  • Monoamine oxidase inhibitors
  • Atypical antidepressants

It’s important to remember that certain dietary supplements like St. John’s wort, an over-the-counter herbal supplement often used for depression, may have drug interactions as well. Side effects such as dizziness, drowsiness, and difficulty concentrating can occur when St. John’s Wort is combined with alcohol. Avoid or limit the use of alcohol while being treated with St. John's Wort. Always check with your pharmacist for herbal supplement and other dietary supplement drug interactions.

Common Antidepressants*

Generic Name Brand Name
aripiprazole Abilify
amitriptyline Elavil
bupropion Wellbutrin
citalopram Celexa
clomipramine Anafranil
desipramine Norpramin
desvenlafaxine Pristiq
duloxetine Cymbalta
escitalopram Lexapro
fluoxetine Prozac
trazodone Desyrel
fluvoxamine Luvox
paroxetine Paxil
risperidone Risperdal
sertraline Zoloft
mirtazapine Remeron
nefazodone Serzone
venlafaxine Effexor
vilazodone Viibryd
St. John’s Wort Dietary Supplement

*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions.

Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant typically reserved to treat depression that is not responding to other medications, but can cause serious interactions. They 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 content, serious heart-related effects, such as dangerous high blood pressure (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

Common Monoamine Oxidase Inhibitors*

Generic Name Brand Name
isocarboxazid Marplan
phenelzine Nardil
tranylcypromine Parnate
selegiline Eldepryl

*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions.

Types of Drug Interactions With Alcohol

Further information

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