Substance Abuse
6 minutes

Should You Mix Antidepressants And Alcohol?

Medically Reviewed
Last Medically Reviewed on: April 30, 2023

It’s pretty common for teenagers who are dealing with mental health challenges to get a prescription for antidepressant medications. These medications are generally safe, can be highly effective, and often help teenagers succeed in school and in their personal lives as well as just generally feel better. But should you mix antidepressants and alcohol [1]?

While antidepressants aren’t necessarily something that everyone needs to take forever after they get a prescription, they are most effective when you take them every day over an extended timeframe. Most antidepressants don’t even reach full effectiveness until you’ve been on your full maintenance dose of the medication for at least one month.

Taking any long-term medication like that can sometimes be challenging, especially for teens who may struggle to remember long-term medications, may not want to take medications – especially if there is social stigma about that medication. Taking certain medications may also feel restrictive to teens.

For example, most antidepressants come with a warning about drinking alcohol [2]. That can feel like a huge restriction to a lot of teens, especially if they think that they are likely to still be using the medication by the time they turn 21 and alcohol becomes legal.

Not to mention that drinking is incredibly common for many teens, despite being illegal. Taking a medication that makes drinking alcohol even more dangerous can feel like an unfair restriction to some teens, especially if they have friends who are already drinking, or had been drinking themselves before taking the medication.

So, while teen drinking is never something we would encourage, it’s important to be realistic about the possibility, the risks, and how teens can feel about not having the option.

With that in mind, let’s talk about why that warning exists on many antidepressants, what the risks and side effects of combining antidepressants and alcohol really are, and if the combination is more dangerous for the teens in your life than it would be for the adults.

antidepressants and alcohol

Is It Safe To Mix Antidepressants And Alcohol?

The first thing we need to address for the combination of alcohol and antidepressants is if it’s even safe to mix them. After all, if there are serious dangers associated with the combination of these two drugs, that should be all the information we need.

That said, the safety of combining antidepressants and alcohol can be highly variable, not just in terms of how much you’re taking, but also how often you drink, how much you drink, which drugs you’re taking, and your individual metabolism and health status.

For instance, people taking a specific class of antidepressants, monoamine oxidase inhibitors (MAOIs) can have a dangerous spike in blood pressure when combined with alcohol, or even certain foods. It’s important for people who take these medications, regardless of their age, to understand what beverages and foods they need to avoid and to be careful about avoiding those substances while they take that medication.
But other more common types of antidepressants, like selective serotonin reuptake inhibitors, or SSRIs, generally come with less risk when combined with other drugs or alcohol. There are still risks, of course, and you should avoid certain foods and beverages while taking them, like grapefruit or grapefruit juice [3], but the risks are generally lower.

That said, drinking alcohol while taking any medication, including over-the-counter medications you can get without a prescription, can increase your risk and especially may increase your risk of having what’s called an adverse medication reaction. Basically, adverse medication reactions are negative consequences of taking a medication more severe than your typical side effect. Most often, these reactions happen when you’re taking more than one medication or drug at the same time, or when medications are mixed with certain foods or health conditions.

For example, some medications may cause an adverse medication reaction if you get too dehydrated while taking them. Or you may not be able to take over-the-counter pain or sleep medications while using certain prescriptions, because there may be an adverse medication reaction when you combine them.

That happens with alcohol as well. Alcohol is actually highly reactive to other medications, and can also change how quickly your body can process and eliminate a medication because your liver and kidneys are busy dealing with the alcohol.

Here are some of the more common side effects, though this list is still far from complete and doesn’t include all of the possible side effects or reactions to combining antidepressants and alcohol.

Remember that there are many different antidepressants, and each antidepressant will respond a little differently to alcohol.
Your dose, body weight, and how much you drink can all lead to different reactions.
The more of a medication you take, the higher your dose, the more likely you are to have severe reactions or just more reactions when you combine antidepressants with alcohol.

  • Blood pressure changes
  • Dizziness
  • More extreme mood changes
  • Nausea
  • Vomiting
  • Loss of coordination
  • Headaches
  • Fatigue
  • Increased sleepiness
  • Lowered inhibitions.
  • Increased risk of both overdose and alcohol poisoning

While these side effects are side effects of alcohol, antidepressants, or both, they will generally be much stronger side effects when the two types of drugs are combined.

Because teenagers often have a stronger reaction to alcohol than adults, and a less predictable reaction to antidepressants compared with adults, teens may also have a more exaggerated set of reactions compared with adults who use the same combination

Risks Of Mixing Antidepressants And Alcohol

There are a wide range of risks that come with combining antidepressants and alcohol, especially for teenagers. We can’t list all of them here, but there are a few key risks we want to highlight.

The first is that this combination can lead to your inhibitions being lowered more than they would be with alcohol alone. That means that teens who combine these drugs are at increased risk of dangerous behaviors like driving while intoxicated may be more likely to engage in unsafe sex, and may be less able to extract themselves from potentially dangerous situations.

In addition, people who combine antidepressants and alcohol may also be more likely to get sleepy or pass out sooner with fewer drinks consumed. So, you should also be prepared to have increased drowsiness.

The last risk we want to highlight is that drinking alcohol while taking antidepressants can lower the effectiveness of the antidepressant, and that effect generally lasts a lot longer than the intoxication from alcohol.

Teens who drink while taking antidepressants may notice that they are more depressed than usual for up to a week after consuming alcohol. They may also fall into deeper depression than usual, and be more likely to engage in risky or dangerous behaviors because of that depression.

Suicidal ideation and self-harm can also both be serious risks of combining antidepressants and alcohol in some cases.

Should You Mix Alcohol And Antidepressants?

Ultimately, drinking alcohol with antidepressants isn’t generally a good idea, especially if you’re talking about having more than just the occasional drink.

That said, the decision whether or not to drink is a personal one and one that, for teens, is likely to be made in the moment rather than thought out far ahead of time.

If you’re worried about a teen drinking on antidepressants or are worried about a teen who is already drinking more than you’d prefer, it may be time to have a conversation with them that outlines your concerns and safer behavior patterns they could engage in instead.

Again, we don’t advocate for teen drinking. It’s illegal, it’s dangerous, and it can have serious and long-lasting mental health consequences.

But that doesn’t mean that it’s going to stop happening tomorrow.

Taking a realistic approach to teen drinking with your teen can be a good way to show understanding while also helping them adopt healthier or more responsible practices.

You can encourage behaviors like, if your teen is going to drink, choosing to only have a single drink, or choosing a low-alcohol beverage as opposed to one with a lot of alcohol. Remind your teen that you are happy to come get them if any situations get out of hand, or if they need a ride home. Tell them that they don’t need to try and handle potentially dangerous situations on their own – and that leaving instead of drinking is a valid option if their friends are pressuring them to drink when they don’t want to, or to drink more than they want to.

Remind them that mistakes happen, and you aren’t asking them to be perfect. But also feel free to remind them of the risks or why you’re concerned about their drinking if that’s called for.

Does your teen need a little extra support?

Does Your Teen Need A Little Extra Support?

If your teen is having a hard time managing their mental health or is dealing with substance abuse issues, they deserve a little extra support from expert care providers that understand how treating teens is different from treating adults.

Your teen can thrive, with the right knowledge, coping skills, and an opportunity to better understand themselves and why they’re feeling the way they do.

At BasePoint Academy, we understand teens, and we understand the unique mental health and substance use challenges facing teens today. There is hope, and there are more options for treatment than you might think.

Contact us to learn more about our teen programs, why it’s important for teens to receive treatment in a teen-centered space, or to schedule a complimentary assessment for your teen.

 

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[1] T, B. Verywell Mind. (2022, December 18). Prescription and OTC medications you should never mix with alcohol. Retrieved from https://www.verywellmind.com/mixing-alcohol-and-medication-harmful-interactions-67888 on 2023, February 23

[2] Daniel K. Hall-Flavin, M. D. Mayo Clinic. (2017, June 9). Antidepressants and alcohol: What’s the concern?  Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants-and-alcohol/faq-20058231 on 2023, February 23

[3] U.S. Food and Drug Administration. (n.d.). Grapefruit juice can affect how well some medicines work.  Retrieved from https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix#:~:text=Many%20drugs%20are%20broken%20down,much%20drug%20in%20your%20body on 2023, February 23