Skip to Content

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:

  • 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

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
chlorpromazine none available
fluphenazine none available
haloperidol Haldol
loxapine Adasuve
molindone none available
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

Sources

  1. Freed E Alcohol-triggered-neuroleptic-induced tremor, rigidity and dystonia. Med J Aust 2 (1981): 44-5.
  2. Product Information. Seroquel (quetiapine). Zeneca Pharmaceuticals, Wilmington, DE. Accessed Nov. 20, 2019.
  3. Lutz EG Neuroleptic-induced akathisia and dystonia triggered by alcohol. JAMA 236 (1976): 2422-3.
  4. Product Information. Perphenazine. Sandoz. Princeton, NJ. Accessed Nov. 20, 2019 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/089683s024lbl.pdf
  5. Product Information. Nuplazid. Acadia Pharmaceuticals. SAn Diego. Accessed Nov. 21, 2019 at 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.