Two leading psychiatrists speak to common questions about taking antidepressant meds, including whether it's safe to mix Lexapro and alcohol.
Can You Mix Lexapro and Alcohol? Two Expert Doctors Respond
Published on Jan. 22, 2025
About the experts:
- Hannah Snyder, MD, is a board-certified psychiatrist and addiction specialist with the Cleveland Clinic. She completed her psychiatry residency at the Cleveland Clinic Foundation and fellowship in addiction psychiatry at Case Western Reserve University, also in Cleveland.
- Leslie Pillow, MD, is a board-certified psychiatrist at the Ohio State University Wexner Medical Center, specializing in addiction medicine.
New York Times data in 2022 suggested around 14% of Americans took an antidepressant medication before the pandemic years, which became an even more emotional time for many. Common antidepressant brand names are Prozac, Zoloft, and Lexapro, with research suggesting that patients ask whether Lexapro and alcohol can be taken simultaneously. It’s a wise question, since both this drug and alcohol affect brain function, and important to understand how they might interact and which risks are involved.
“Lexapro is part of a class of medications called SSRIs (Selective Serotonin Reuptake Inhibitors),” explains Leslie Pillow, MD, a board-certified psychiatrist and addiction medicine specialist with the Ohio State University Wexner Medical Center. “SSRIs work by increasing serotonin levels and serotonergic activity in the brain.” This mood-regulating mechanism is why Lexapro is commonly prescribed to manage conditions like depression and anxiety. However, alcohol—known for its depressive effects on the brain—can counteract these benefits, amplify side effects, and even pose safety risks.
Ahead, Dr. Pillow and Hannah Snyder, MD, a board-certified psychiatrist and addiction medicine specialist with the Cleveland Clinic, share valuable insights on the risks of combining the two, along with how alcohol consumption can affect your mental health.
What is Lexapro?
“Lexapro, or escitalopram, is an antidepressant medication,” Dr. Snyder says. “It works by blocking the reabsorption of serotonin into neurons, which increases the amount of serotonin in the brain.”
Serotonin is a chemical messenger that plays a key role in mood regulation, and boosting its availability can help improve symptoms of depression and anxiety. For this reason, it is commonly prescribed to treat a range of anxiety and depressive disorders, including:
- Major depressive disorder
- Generalized anxiety disorder
- Panic disorder
- Obsessive-compulsive disorder
- Post-traumatic stress disorder
- Social anxiety disorder
- Premenstrual disorder
Side effects of Lexapro
Dr. Snyder shares some of the most common side effects of Lexapro:
- Gastrointestinal symptoms, such as reduced appetite, nausea, diarrhea, or constipation
- Insomnia or excessive sleepiness
- Headache
- Shakes or tremors
- Dizziness
- Sweating
- Bruising or bleeding
- Sexual dysfunction
Can you mix Lexapro and alcohol?
No, it is not recommended to mix Lexapro and alcohol, as both psychiatrists make clear. Drinking alcohol, especially during the initial stages of taking Lexapro, can worsen potential side effects of the medication. “Until you know how your body will react to Lexapro, I would recommend avoiding alcohol altogether,” advises Dr. Pillow.
Is it okay to have one drink while on Lexapro?
“Drinking alcohol while taking Lexapro is generally not recommended,” says Dr. Snyder. Both alcohol and Lexapro can impair alertness and coordination, and when combined, these effects may intensify. This could leave you feeling more impaired than if you consumed either substance on its own, notes Dr. Snyder. However, the guidance may vary depending on the individual.
If you’re considering having one drink, it’s important to consult both your doctor and pharmacist. They can explain how alcohol might interact with your medication and assess whether it’s safe for you. For some patients, even one drink is not advisable, particularly those with an alcohol use disorder, liver disease, or a history of severe depression.
If your doctor approves the occasional drink and you’re wondering about the best timing in relation to taking Lexapro, Dr. Snyder notes that the timing likely won’t have a significant impact. However, she emphasizes the importance of adhering to your doctor’s instructions regarding when to take the medication to prioritize your safety.
Tips for safe drinking (if approved by your doctor)
If your doctor has given you the go-ahead to have an occasional drink, here are a few precautions to help you stay safe:
- Stay hydrated: Drink plenty of water alongside alcohol to prevent dehydration.
- Eat before drinking: Having a meal or snack can slow alcohol absorption and minimize your drink’s effects.
- Avoid driving and operating machinery: Never drive or engage in tasks that require concentration or coordination after drinking.
- Know your limits: Adhere to the amount of alcohol your doctor has approved. According to the U.S. Dietary Guidelines, adults who choose to drink and haven’t been advised otherwise should limit their intake. For women and adults over 65, the guideline is one drink or less per day (no more than seven drinks per week). For men under 65, the limit is up to two drinks per day (no more than 14 drinks per week).
Why you shouldn’t drink alcohol when taking Lexapro
Combining Lexapro and alcohol is generally discouraged due to the potential for serious side effects and health risks. Both substances affect brain function, and when used together, they can interfere with Lexapro’s effectiveness while increasing the likelihood of adverse reactions. Here’s what you need to know about why mixing the two is not advised:
Mixing Lexapro and alcohol might make you more depressed
Alcohol is a depressant and can counteract the positive effects of Lexapro, worsening symptoms of depression or anxiety. Combining the two may also increase the risk of mood swings and emotional instability.
The side effects of taking Lexapro could get worse
Alcohol can exacerbate Lexapro’s side effects, making them more intense and potentially dangerous. These include:
- Drowsiness
- Dizziness
- Impaired judgment
- Increased risk of falls or accidents
Lexapro and alcohol could make you sleepy
Both alcohol and Lexapro have sedative effects. When combined, they can amplify feelings of drowsiness, increasing the risk of accidents and making it unsafe to drive or operate machinery.
You might experience brain fog and slower reaction times
Alcohol can impair cognitive function, leading to brain fog and difficulty concentrating. When paired with Lexapro, this effect can intensify, impacting your ability to make decisions or respond quickly in critical situations.
Do not stop taking Lexapro so you can drink
“I don’t recommend that people skip doses of Lexapro or stop taking it in order to drink alcohol,” says Dr. Snyder. “In order for Lexapro to be most effective, we have to have that daily dose to maintain the appropriate level of Lexapro in the blood.”
Skipping doses can reduce the effectiveness of Lexapro and may worsen mood symptoms. Abruptly stopping the medication can also lead to withdrawal-like symptoms, such as flu-like discomfort, electric shock sensations, irritability, mood swings, headaches, and nausea.
Alcohol’s effects on mental health
It’s important to know that even without taking Lexapro, alcohol can negatively affect mental health. It may:
- Increase feelings of anxiety or depression
- Disrupt sleep patterns
- Contribute to impulsive or risky behavior
- Worsen symptoms of existing mental health conditions
- Lead to new mental health conditions in individuals who have not previously been diagnosed
“It is important to be mindful of the effect alcohol is having on your mental health,” says Dr. Pillow. “Discuss with your doctor if you feel alcohol is having a negative effect on your mental health and overall life.”
If you have any questions regarding Lexapro and alcohol, it’s always best to consult your doctor. With their knowledge of your medical history, they can provide the most personalized guidance to support your overall health.
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