Antidepressants and Alcohol
Depression is one of the most prevalent mental health disorders in the U.S.1 In 2017, around 17.3 million American adults, or 7.1% of the population, experienced at least one major depressive episode and 11 million of these individuals struggled with severe functional impairments as a result of their depression, such as interpersonal relationship issues, being unable to maintain work productivity, or perform the usual activities of daily life.1
Around 65% of the people diagnosed with major depression received a combination of medications and treatment from a healthcare professional; only 6% were treated with antidepressant medication alone.1,2,3 People who use antidepressants should be aware of the dangers of mixing these medications with alcohol, as doing so can diminish the intended therapeutic effect as well as give rise to potentially unpleasant and even deadly interactions.
Why Are They Prescribed?
Antidepressants are medications that are commonly prescribed to treat depression, but they are also sometimes used to treat other conditions, such as obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, or certain types of chronic pain.2 It’s not entirely clear how antidepressants work, but they are thought to help increase the activity of specific neurotransmitters (brain chemicals) like serotonin, which play a role in how you feel.2 Their neurochemical effects may also modify pain signaling within the nerves, which may explain how they work to help treat some chronic pain conditions.2
As with many medications, antidepressant use may be associated with some unpleasant, but often temporary, side effects. These side effects most frequently include headaches, nausea, restlessness, sleep disturbances, and sexual issues.3 People who take antidepressants should inform their doctors if they use any other medications or over-the-counter supplements, as the combination may result in additional side effects and adverse interactions.
Types of Antidepressants
There are many types of antidepressants and everyone reacts differently to them, so it can take time and patience to find the right combination. If one type doesn’t work or causes side effects, your doctor may recommend a different one. Some of the common types of antidepressants include:2,4
- Selective serotonin reuptake inhibitors (SSRIs). These medications are often the first line of treatment for depression and anxiety because they have a relatively lower risk of side effects compared with some of the previously used classes of antidepressants. SSRIs include medications like fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), and sertraline (Zoloft).
- Tricyclic antidepressants (TCAs). These are older medications that are nowadays less commonly used because they have a lower margin of safety (i.e., they can cause more serious issues if you take too much of them) and they tend to be associated with more unpleasant side effects. However, they are still reserved for use in instances when they may be more effective for people who do not respond to other antidepressant medications or for treatment of other mental health issues such as obsessive-compulsive disorder. TCA medications include amitriptyline, clomipramine (Anafranil), imipramine (Tofranil), and nortriptyline (Pamelor).
- Monoamine-oxidase inhibitors (MAOIs). These are also older medications that were the first type of antidepressant on the market but are now less commonly prescribed due to the risk of adverse drug interactions and potentially severe side effects. People who use these medications also need to follow a special diet (i.e., a tyramine-free diet to decrease the risk of serotonin syndrome). MAOIs include phenelzine (Nardil) and tranylcypromine (Parnate).
- Other types of antidepressants include:
- Serotonin-noradrenaline reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq) were developed in the hope of being more effective antidepressants than SSRIs, but the evidence to support this is unclear.
- Norepinephrine–dopamine reuptake inhibitors, including medications like bupropion (Wellbutrin), which is sometimes prescribed in combination with other antidepressants as a more ‘activating’ medication to help increase energy levels.
- Noradrenaline and specific serotonergic antidepressants, such as mirtazapine (Remeron), which are prescribed for their sedating effects and can help with insomnia.
Effects of Mixing Antidepressants and Alcohol
You should not drink alcohol while taking antidepressants because alcohol can worsen symptoms of depression, making them more difficult to treat.5 In addition, it can increase the risk of and worsen side effects, such as drowsiness or dizziness, as well as increase your risk of overdose.6 Specific side effects and interactions can develop if you take certain antidepressants, especially if you take MAOIs and drink alcohol, which can increase one’s risk of developing serious cardiovascular issues such as dangerously high blood pressure and hypertensive stroke.6,7
Mixing antidepressants and alcohol can also be fatal.7 Not only does alcohol change the way antidepressants work, making them potentially less effective, it could also increase suicidality in connection with worsened depression.7
Alcohol Abuse and Alcoholism
Alcohol is one of the most-commonly abused substances in the world. When people chronically abuse alcohol and are unable to control their drinking, they may be suffering from alcoholism.8 The clinical term used to diagnose alcoholism is called alcohol use disorder (AUD).8 Around 15 million people in the U.S. are believed to have an AUD.8
AUD is a chronic, relapsing brain disorder characterized by the inability to control your drinking despite the negative effects it has on your life.8 A few of the warning signs that you or someone you care about may have an alcohol use disorder include:8
- Drinking more than you originally intended.
- Feeling unable to reduce your alcohol use, even if you want to.
- Craving alcohol.
- Experiencing problems at home, work, or school because of drinking.
- Giving up activities you normally enjoy so you can drink.
- Over time, feeling like you need to drink increasingly more to achieve the sought-after intoxicating effects (known as tolerance).
- Experiencing unpleasant effects, such as shakiness, irritability, sweating, nausea, or anxiety after you stop drinking (known as withdrawal).
Alcohol addiction and depression are often comorbid conditions, meaning they occur together. Co-occurring alcohol use and depression can play into a maladaptive cycle of compulsive drinking with alcohol worsening depression, and depression in turn leading to increased alcohol consumption.5
There may be a genetic component to this co-occurrence; one study showed that alcoholism and depression were found more frequently in first-degree relatives of study participants with alcoholism than in relatives of control participants.9 When alcohol addiction and depression occur together, the outcomes are potentially much worse than those for either disorder alone, including an increased risk of suicidality.10 People who have an AUD are 2.3 times more likely to also have suffered from depression in the previous year.10
How to Stop Drinking Alcohol
If you are taking antidepressants while drinking, you may need to discuss with your psychiatrist or other prescribing physician your level of alcohol use as it could be negatively impacting the effective management of your mental health or introducing other health risks. In many cases, one of the more tangible ways to support your mental health and reduce the likelihood of increased mental and physical health issues is to address the alcohol abuse problem and stop drinking all together. However, this should also be discussed in detail with your doctor or other treatment professional, as abruptly quitting drinking can result in a dangerous withdrawal syndrome in some individuals.
Not only can drinking worsen depression, but it can also lead to serious medical conditions like liver disease and cardiovascular issues. Thankfully, many people are able to improve their mental and medical health issues with treatment of their AUD. It’s estimated that one-third of people who complete addiction treatment experience no additional symptoms 1 year later, with others who have been able to substantially cut down on their drinking similarly experiencing fewer problems related to alcohol use.11
For many people, the first step in quitting alcohol abuse is to enter medical detox. Detox should not be considered as a replacement for comprehensive rehabilitation, but it remains an indispensable step during early recovery efforts. Medical detox entails a set of interventions designed to help you wean off alcohol gradually and safely to minimize the risk of harm and unpleasant or even dangerous side effects.
After you have completed detox, you may transition to a treatment center or other form of ongoing AUD management efforts to better address the addiction and further examine the underlying causes and triggers that can otherwise lead to relapse and sustain unhealthy drinking patterns. Finally, as addiction is condition that commonly requires long-term, if not lifelong management, regular participation with some form of aftercare such as 12-step support groups like Alcoholics Anonymous and/or individual counseling or group therapy can help promote sobriety and prevent relapse.
Get Treatment For Alcoholism
If you’re ready to seek treatment for alcoholism, American Addiction Centers (AAC) can help. Alcohol.org is a subsidiary of AAC which is a nationwide provider of rehab centers. With a contingent of doctors, therapists, and other treatment professionals, your AAC treatment team will address the comorbidity of depression and alcoholism and can tailor your mental health and recovery treatment plans to offer you a comprehensive, integrated approach to manage both your substance use and mental health issues.
If you’re interested in learning more about your treatment options, our admissions navigators are available to chat with you 24/7. Call our hotline at 1-866-984-8372 to get started today. All calls are 100% confidential.