Antipsychotic Medications and Alcohol Interactions
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 20, 2019.
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:
- 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:
- drowsiness, sedation or coma
- respiratory depression
- poor decision making
- slowed thinking
- low blood pressure (hypotension)
- a change in body temperature
- a change in heart rate
- hazards when driving, operating machinery or engaging in risk activities
- 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
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
Table 2. First Generation Antipsychotics
|Generic Name||Example Brand Names|
*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.
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- 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 Nov. 20, 2019.
- Lutz EG Neuroleptic-induced akathisia and dystonia triggered by alcohol. JAMA 236 (1976): 2422-3.
- Product Information. Perphenazine. Sandoz. Princeton, NJ. Accessed Nov. 20, 2019 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/089683s024lbl.pdf
- Product Information. Nuplazid. Acadia Pharmaceuticals. SAn Diego. Accessed Nov. 21, 2019 at https://www.nuplazid.com/sites/nuplazid/files/pdf/NUPLAZID_Prescribing_Information.pdf
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.