The Risks of Drinking Alcohol While Taking Lexapro

Woman contemplating whether to drink alcohol because she is taking Lexapro.

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Lexapro is a commonly prescribed antidepressant that should be used with caution if mixed with alcohol. Lexapro and alcohol together can cause side effects such as dizziness, changes in mood, increased anxiety, drowsiness, nausea, and sleep problems. Combining the two substances can also lead to more serious interactions, including worsening depression, liver problems, and serotonin syndrome.

How Lexapro Works

Lexapro is the brand name for the generic drug escitalopram oxalate. It’s a selective serotonin reuptake inhibitor (SSRI) that is commonly used to treat generalized anxiety disorder, depression, and other mental health issues.

It works by blocking the reuptake of serotonin, the neurotransmitter that affects a variety of functions in the body and mind. It helps balance out brain chemicals that contribute to anxiety and depression.

SSRIs are among the safest classes of antidepressants, so they’re frequently prescribed. But this doesn’t mean Lexapro is completely risk-free. And combining it with alcohol could increase your risk of problems.

Mental Health Issues and Alcohol Use Disorder

Alcohol and depression sometimes go hand in hand. And there’s the age-old question of which to treat first? Well, most researchers and clinicians currently suggest that alcohol use disorder and depression should be treated at the same time.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), symptoms of an alcohol use disorder include:

  • Difficulty limiting the amount of alcohol you consume
  • Wanting to cut down on how much you drink or making unsuccessful attempts to drink less
  • Spending a lot of time drinking, getting alcohol, or recovering from alcohol use
  • Feeling a strong craving or urge to drink alcohol
  • Failing to fulfill obligations at work, school, or home due to alcohol use
  • Continuing to drink alcohol even though it’s causing physical, social, legal, or relationship problems
  • Giving up or reducing social activities, work activities, or hobbies
  • Using alcohol in situations when it’s not safe, such as swimming or driving
  • Developing a tolerance to alcohol so you need more to feel its effects or you have a reduced effect from consuming the same amount
  • Experiencing withdrawal symptoms, such as nausea, sweating, and shaking when you don’t drink, or drinking to avoid these symptoms

A common way depression is treated is with antidepressant medication. But if alcohol intake isn’t addressed, medications like Lexapro might not be effective.

Research shows heavy drinking can counteract the benefits of antidepressant medication. Therefore, prescribing antidepressants may not reduce depressive symptoms in individuals who continue to drink.

However, when people begin taking SSRIs to feel better, they may tend to drink less. One study showed that the use of antidepressants decreased alcohol consumption in depressed men over the course of a year.

However, when treating someone who has an alcohol use disorder, a physician who decides to prescribe Lexapro may also recommend talk therapy or a 12-step program as part of the overall treatment plan.

If a patient is actively drinking heavily, a physician may recommend a detox program to address withdrawal symptoms or a rehabilitation program prior to prescribing an SSRI. In some cases, medication-assisted therapy can also be an option. For example, naltrexone as the oral medication Revia or in the long-acting injectable form of Vivitrol might be prescribed to help reduce alcohol cravings.

Lexapro and Alcohol

Of course, not everyone who takes Lexapro and drinks alcohol will have an alcohol use disorder. Some individuals who are taking Lexapro may want to drink in moderation or enjoy an occasional alcoholic beverage.

This doesn’t mean that drinking while taking Lexapro is completely safe. Caution needs to be used as combining the two can lead to drowsiness and impaired alertness. In addition, if you’re being prescribed Lexapro, it most likely means you have a mental health condition, like anxiety or depression. In general, it’s not recommended that individuals with mental health issues consume alcohol as it can worsen these conditions.

According to the FDA, clinical trials have not found that Lexapro worsens the motor and cognitive effects of alcohol. But they also report that alcohol use while on Lexapro is not recommended.

Drinking alcohol while on Lexapro might increase your risk for serious side effects. It’s also important to talk to your doctor before drinking alcohol when you are taking any medication.

Drinking alcohol in an attempt to cope with depression can also increase the likelihood that you’ll develop an alcohol use disorder. Drinking could also potentially damage your liver, the organ responsible for breaking down substances, medications, and toxins, further impacting how your body handles these. 

Possible Interactions When Drinking

Mixing alcohol and Lexapro will affect each person differently. The dosage you take may also play a role. Those who take the maximum dosage for depression (20mg of Lexapro) may be at an even higher risk of experiencing side effects or complications from drinking alcohol.

Drinking while taking Lexapro may cause:

  • Increased anxiety
  • Decreased effectiveness of Lexapro
  • Increased depression
  • Liver problems
  • Drowsiness

Alcohol could also increase the risk of side effects from the Lexapro. And side effects might become more severe when Lexapro is mixed with alcohol. Side effects may include:

  • Nausea
  • Insomnia
  • Dry mouth
  • Diarrhea
  • Sleepiness

There is some evidence that antidepressants like Lexapro might lead to an increase in suicidal thoughts and behaviors, particularly in children, adolescents, and young adults. It’s most likely to occur during the first few months of treatment or when a physician changes the dosage. Since alcohol can worsen depression, drinking while on Lexapro may increase this risk even more.

Talk to Your Doctor

If you’re interested in starting Lexapro, be honest with your physician about your drinking habits. Lexapro is usually taken over a long period of time, so it’s important to discuss how often and how much you usually drink.

Your doctor may tell you to avoid alcohol altogether while you’re on Lexapro, or they may say that it’s fine to have a drink from time to time. Everyone’s situation is different, and your doctor will advise you what’s best in your circumstance.

3 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ramsey SE, Engler PA, Stein MD. Alcohol Use Among Depressed Patients: The Need for Assessment and Intervention. Prof Psychol Res Pr. 2005;36(2):203-207. doi:10.1037/0735-7028.36.2.203

  2. Graham K, Massak A. Alcohol consumption and the use of antidepressants. CMAJ. 2007;176(5):633-637. doi:10.1503/cmaj.060446

  3. Lexapro: US Food and Drug Administration

By Amy Morin, LCSW
Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk,  "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.