Most psychiatric drugs bear some version of the warning: “Do not drink alcoholic beverages when taking this medication.”

In reality, though, many people taking psych meds drink anyway. They have various reasons: not wanting to curtail their fun, not putting much stock in the warnings, or simply thinking it’s easier to take a proffered drink than explain why they’re turning it down.

Doctors oftentimes don’t bother to talk to patients about potential dangers. Or they tell patients not to drink, but don’t explain why. To make matters worse, because of a lack of studies on the subject, patients inclined to do their own research will have a hard time just how risky it is to drink while taking various kinds of psychiatric medications (I’ve written elsewhere about this troubling lack of evidence).

A widely publicized study that came out last month in the journal Neurology underscores the problem. The findings, which pooled data from 16 studies, showed that people taking SSRI antidepressants like Zoloft or Celexa were 40 percent more likely to suffer a type of stroke caused by bleeding in the brain and 50 percent more likely to suffer any bleeding in the skull.

13 Comments to
Mixing Meds and Alcohol: Just How Dangerous Is It?

Before posting, please read our blog moderation guidelines. The comments below begin with the oldest comments first. Click on the last comments page to jump to the most recent comments.

  1. The worst part is that some people mix these medications with alcohol on purpose because they like the way it makes them feel. A pretty heavy price to pay for one night having a good time.

  2. I am glad to see this being talked about. I take antidepressants. All the warnings simply said do not mix with alcohol. They also all say may cause suicidal behaviors. Needless to say, I and many others may take the list of warnings with a grain of salt… because some of them are just that. I looked online to see the dangers of drinking while on antidepressants. I could not find anything concrete or anything besides “it is dangerous.” Driving a car can be dangerous. I found out a the rough method the dangers of mixing the two.

    There really needs to be more research. What specific meds? Can a certain level of alcohol be consumed or none? What are the medical and psychiatric risks? How great are those risks?

  3. There’s no need to admit to taking drugs for your mental health when out partying. When refusing a drink, how about saying, “I’m trying to keep my weight down.” or “I’m trying to be healthier.” If someone is pushing you to drink when you refuse, they aren’t much of a friend.

  4. I love that the writer spoke about her own experience. Mine is similar except that the drug is Prozac and the drinking (some periods daily) has always to excess (ex 1.5 bottle wine, or 8+ beers). My take on the warning is that it is drug company covering their legal ass. Happily, I have not had any negative effects from my (admittedly extremely reckless) drinking. Point being that if my level of drinking didn’t cause a problem, I really think a glass or wine or a couple of beers won’t hurt.

    I have since (7 weeks now) quit alcohol after learning what I am doing to my brain. Need that.

  5. The real danger comes in when mixing alcohol and opiates. Too many people have died from mixing their prescribed pain pills with a few drinks or glasses of wine. Sometimes they forget if they’ve taken a dose of pain pills so they take 2 more. My sister in-law, who thought she knew everything, died this way last year. It was clearly an accident.

    I had even gently suggested to her just a few months before her death that she might be addicted to pain killers. Of course she denied that. She was also in denial about her alcohol consumption. I had to oh, so carefully touch on these subjects or she was liable to become extremely angry and say really bad things about me to my brother.

    It’s a sad thing when I think about her, the enormous number of celebrities who’ve died this way, and all the countless others we don’t hear about.

    People just don’t get it!!!

  6. Is there a risk even if you don’t get slightly tipsy let alone drunk? I always thought it just made the effects of alcohol come on more quickly, and that due to the medication causing things such as CNS depression, being drunk was even more dangerous than it otherwise would be.
    I’ve only experienced an increased response to alcohol on one medication. Two sips of champagne made me feel like I had guzzled three glasses in quick succession (or at least what I imagine that would be like). Needless to stay, I stopped drinking immediately!
    My psychiatrist has always said to be really careful until you know how the medication and alcohol effects you and NEVER to mix alcohol and benzos. But then she knows that I would never get myself even remotely drunk.

  7. I am a very light drinker, and I hate that the “do not drink” labels are so vague and doctors do not discuss it. I have to go research the information myself. I take opiates for chronic severe noncancer pain, as well as antidepressants and other medications that are labeled “do not drink alcohol”, but going through the studies shows very little evidence of harm from interaction with small amounts of alcohol.

    It is more frightening because there are meds that can NOT be mixed with alcohol at all in any amount, how does one figure out the difference? The pharmacist isn’t going to tell us, they are just going to say “do not drink.” I want to know whether that means “no alcohol” or “very little alcohol.” I know many are incapable of making that distinction, but I have chronic gastritis and can’t drink much anyway ;)

    The alcohol/opiates interaction is, in my mind, something that can’t be reduced to a label. The interaction is going to be completely different for an opiate tolerant patient on a steady dose vs. someone who is either new to opiates, has recently started a higher dose, or is monkeying around with their doses without their doctor’s permission/abusing the medication. Those are the danger zones, where deaths are most likely to occur (also more likely with certain medications). A properly medicated patient should never be high outside of a hospital/surgical setting. I read a lot of message boards and see a lot of improperly medicated people, it’s impossible to tell whether they are that way by choice or not.

    • Estarianne, you make a really interesting point about how the blanket warnings may actually be more dangerous – not to mention more confusing – than having specific ones. Some drugs are flat-out much more dangerous to mix with alcohol than others. However, the effects can be dose dependent, both with the amount of the drug and the amount of alcohol. Here, as you note, tolerance comes into play. Someone might drink frequently but lightly while taking a certain medication. But from most warnings, it’s difficult to tell if that means they’re probably in the clear because the real issue is that alcohol enhances, say, the sedative effects of the meds (as is the case with opiates for pain and benzodiazepines for anxiety), or whether it causes, say, liver damage by frequently combining the medication and alcohol, even in small amounts. I agree with you that doctors need to explain in much more detail what the specific risks are. They should specifically inquire about patients’ drinking habits.

    • That is a very good point!

    • If you are Physically dependant on opiates and taking an anti depressant why do you feel the need to drink at all. Alcohol and opiates potentiate each other. Having a higher tolerace to opiates does not mean it is safe to drink in small amounts.

  8. I take 450mgs of Wellbutrin. I have a glass of wine a day. I looked at the research that I could understand and while it said you should not drink, it also said that a person should not quit drinking because that could cause seizures…you should quit little by little.

    But really, one glass of wine a day? Are they only speaking to people who drink much more than that? I told my doctor about my alcohol use and he did not think it was a problem (maybe he is wrong, docs can be wrong). But it seems to me these blanket statements (mentioned above) are more for “safe than sorry” than nuances for individual use and protection from lawsuits. I want to see a study that shows a statistically significant correlation between low-moderate alcohol use and increased seizures.

    • I’d like to see that study, too! A quick search turned up this study, but it’s in mice. As you probably know, taking higher doses of Wellbutrin (450 is a high dose) is associated with a higher risk of seizures than lower doses. But you’re right – one glass of wine a day? My understanding is that alcohol’s effect on the seizure threshold (how “easily” you get a seziure) also depends on the amount you drink. This Powerpoint presentation on the topic is interesting, too (warning – it’s a download)

      • The PP was helpful, I wish I had the talk and Q and A that went with it to fill in the blanks! It says Welbutrin immediate release for lower seizure threshold. The discussions seems to focus on sudden withdrawal of most substances (psych, legal, illegal) as lowering the seizure threshold. Immediate release Welbutrin is very hard to manage because of how quickly it heads through your system, right? I take extended release, hopefully that mitigates factors. Now to find out whether or not I have a high risk for seizures…. I really need to talk to my doctor about this again and get him to look into it more carefully.

  9. Interesting – my meds (benzos) occasionally come with this label – I asked my doctor about it and he said 1-2 glasses of wine were likely okay – it depended on how I felt. So I do occasionally have a glass or two. I’m a very occasional drinker (less than once a month). This article got me worried – but I assume my psychiatrist would know?

    • Trust your psychiatrist, Kaye. He knows how much of the benzo you’re taking and your tolerance to it and can better account for risks. Of course, if you want to do your own research from reliable sources, like peer-reviewed studies on Google Scholar, I would encourage that, too -as long as you discuss your findings with your doc and don’t change your habits without letting him know. Also just make sure to be honest with him if you do sometimes drink more:)

Join the Conversation!

Before posting, please read our blog moderation guidelines.

Post a Comment:


(Required, will be published)

(Required, but will not be published)

(Optional)

Learn more about Dosed now

Check out Kaitlin Bell Barnett's
book, Dosed!

Subscribe to this Blog: Feed

Recent Comments
  • Jeanette: I am a 50-yr-old teacher who has been on bipolar meds for over half of my life. My daughter has ADHD and...
  • vegasangie: What can we do? Evan was so brave and had so much courage for a 15 year old boy. I am 48 and have...
  • Jay: This article very aptly points out the stigma attached to taking these drugs but then seems to stumble in...
  • Kaitlin Bell Barnett: Richard, it sounds like you have a very measured approach to this topic. Very refreshing...
  • Richard: I think that the most important thing that anyone taking any form of anti depressant meds should be aware...
Find a Therapist
Enter ZIP or postal code



Users Online: 12240
Join Us Now!