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Anxiety Medications and Alcohol Interactions

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

The combination of antianxiety medication and alcohol may lead to serious drug interactions, so it is important to understand your risks.

Anxiety is a common disorder with differing levels of intensity. Someone with anxiety typically has chronic, ongoing bouts of worry, fear, or concern, typically out of proportion to the actual troubles that one may be facing in their everyday life. The symptoms can go on for an extended period time, usually months, without relief. You can have more than one anxiety disorder. A combination of medications and psychotherapy are often used for treatment.

The five main types of anxiety disorders include:

The symptoms of anxiety can include:

  • Frequent, ongoing and excessive feelings of worry, nervousness or anxiousness
  • A rapid heart rate and breathing
  • Excessive perspiration
  • Trembling or shaking
  • Feeling tired
  • Trouble concentrating
  • Headaches, stomach upset
  • Avoidance of circumstances that trigger anxiety

A wide variety of medications are used to treat the various anxiety disorders. Benzodiazepines, antidepressants like the selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or the tricyclic antidepressants. Other miscellaneous anxiolytics, sedatives and hypnotics like buspirone (Buspar) might be used depending upon your specific anxiety disorder. Midazolam (Versed) is a preoperative sedative and anesthetic agent often used in the hospital or outpatient surgical setting.

When possible, benzodiazepines should only be used in the short-term and with extreme caution due to sedation, judgment problems, memory impairment, and risk of addiction. Avoid engaging in hazardous activities requiring mental alertness such as operating machinery or driving a motor vehicle while using these medications.

Many anxiety drugs have central nervous system depressant activity and interact with alcohol. Be sure to review your prescription information and ask your pharmacist; do not drink alcohol with benzodiazepines. Certain antidepressants, such as duloxetine (Cymbalta) may also lead to liver damage, and taking it with alcohol may increase that risk.

Combining alcohol and anxiety medications with CNS depressant activity like benzodiazepines can lead to:

  • Extreme drowsiness
  • Dizziness, sedation
  • Slowed breathing (respiratory depression)
  • Overdoses (for example, with Xanax and alcohol)
  • Death

Learn More: Anxiety and Panic Attack Facts

Common Medications Used for Anxiety Disorders*

Generic Name Common Brand Names
alprazolam Xanax, Xanax XR, Niravam
buspirone Buspar
clonazepam Klonopin
diazepam Valium
duloxetine - liver Cymbalta
escitalopram - liver Lexapro
gabapentin Neurontin
hydroxyzine Atarax, Vistaril
lorazepam Ativan
midazolam Versed
sertraline Zoloft
midazolam (pre-surgical sedation) Versed
venlafaxine ER Effexor ER

*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.