Lexapro & Alcohol: Understanding the Risks

What Is Lexapro & How Does it Work?

Lexapro, the brand name of the generic antidepressant escitalopram, is a selective serotonin reuptake inhibitor (SSRI) that works in the nervous system to increase the amount of active serotonin. Serotonin is responsible for many behaviors, including mood, fear, stress response, appetite, addiction, and sexuality.² Just as other antidepressants make you feel, Lexapro can improve symptoms like sleep, appetite, and energy and reduce fear and anxiety.¹ Lexapro has worked well for many people and is taken once daily for most treatments.¹

Lexapro is commonly used as an FDA-approved medication to treat disorders such as:³

• Major Depressive Disorder (MDD) in adolescents (12-17) and adults
• General Anxiety Disorder (GAD)

Lexapro can also have off-label (non-FDA-approved) uses for treating:⁴

• Obsessive Compulsive Disorder (OCD)
• Post Traumatic Stress Disorder (PTSD)
• Eating Disorders
• Panic Disorders 

Side Effects of Alcohol & Lexapro

In the same way that Lexapro works in the brain to treat mental health conditions, it can sometimes cause unwanted side effects. Some mild side effects include changes in sleep, alertness, or mood. Some severe side effects of Lexapro can include heart and blood-related problems, changes in mental status, and rare but serious serotonin syndrome.¹

Alcohol, in any amount, reduces alertness and coordination, leading to poor decision-making and harmful accidents. Repeated alcohol consumption has been linked to depression and can worsen a pre-existing depression diagnosis. This increased depression risk can lead to increased suicidal thoughts, which is already a high risk while taking antidepressants.⁵ There is also the risk of hangovers when drinking alcohol; combined with anxiety can cause a worse hangxiety.

Side effects of Lexapro may include:⁴

• Nausea
• Heartburn
• Tremors
• Diarrhea
• Sexual disorders
• Drowsiness
• Dizziness
• Dry mouth
• Shaking
• Difficulty falling asleep or staying asleep
• Increased sweating
• Weight loss
• Serotonin syndrome
• Seizures
• Suicidal thoughts 
• Irregular heartbeat

Side effects of alcohol may include:⁶

• Poor decision making
• Nausea or Vomiting
• Loss of consciousness
• Injuries from impaired coordination
• Blackouts
• Alcohol poisoning
• High blood pressure
• Memory problems
• Anxiety symptoms
• Depression symptoms
• Liver disease
• Miscarriage
• Fetal alcohol syndrome
• Alcohol dependence

Lexapro & Alcohol Interactions

Both alcohol and Lexapro can change the way our brain works in unexpected ways. When the two substances are combined in any amount, you can experience more severe side effects. Severe side effects of Lexapro can happen unexpectedly, without warning, require immediate attention, and can be life-threatening.⁷ Alcohol itself carries many dangerous risks, and when combined with Lexapro, it makes side effects both more serious and more likely to occur.⁵

Severe side effects of Lexapro and alcohol include:⁸

• Severe nausea and vomiting: Both Lexapro and Alcohol can cause nausea and vomiting. Taking both together can cause their occurrence to be more intense and unexpected.
• Impaired alertness: Alcohol affects judgment and coordination. Lexapro can cause dizziness. This combination can cause dangerous accidents with even a tiny amount of alcohol.
• Feeling sedated or drowsy: Lexapro can cause sedation and drowsiness, and so does alcohol. The effects can be intensified when taken together, making operating vehicles or larger machinery dangerous.
• Decreased Lexapro efficacy: Lexapro works in the brain to increase chemicals that affect mood. Alcohol also affects these chemicals and can make Lexapro not as effective.
• Increased anxiety: Alcohol can cause adverse health effects, including anxiety. When alcohol is combined with Lexapro, it is less effective at treating anxiety.
• Worsened depression: While most think alcohol improves mood, it can cause mild and severe depression. With alcohol also decreasing the effectiveness of Lexapro treating depression, it can create a severe relapse of depression.
• Liver damage: Lexapro and alcohol are both processed in the liver. When used together, liver toxicity and damage can happen more quickly.
• Weight loss: A side effect of Lexapro is weight loss; consistent alcohol use can also lead to weight loss. Drinking alcohol while using Lexapro can increase the risk of weight loss long term.
• Alcoholism: Depression and anxiety are risk factors for alcoholism. Using alcohol while treating a mental health disorder can increase the risk of alcohol dependence.

Can You Ever Drink While Taking Lexapro?

Since Lexapro builds up in your body over time, you cannot simply skip a dose of Lexapro to have a drink. This action will not reduce the side effects of Lexapro or alcohol.⁷ This method can also make depression worse, as Lexapro treatment has the best results when taken daily without interruption.⁸ If having a drink of alcohol is something you would like to do while taking Lexapro, it is necessary to speak with your doctor first. Some doctors may allow or recommend just one drink. If so, it is a good idea to drink slowly and eat food while drinking alcohol to decrease the severity of its interacting effects.

You should never combine alcohol with Lexapro until you know how Lexapro affects you without other interacting substances.⁵ Each person’s body processes alcohol and medication differently. If you take a lower dose of Lexapro, it is not a pass to drink more alcohol. You should also avoid drinking alcohol when you stop taking Lexapro, as this can cause rebound depression or anxiety.

Can Mixing Lexapro & Alcohol Kill You?

Unfortunately, taking too much of either Lexapro or alcohol alone can increase the risk of death, and taking the two together in large amounts will only increase that risk. Binge drinking is the consumption of more than four or five drinks in one sitting and is associated with many health risks.⁹
This is the most dangerous kind of alcohol consumption to take part in while taking Lexapro and should be avoided.

Several factors of mixing Lexapro with alcohol may increase the risk of death, including:

• Amount of Lexapro and alcohol in the body
• Previous health conditions
• Tolerance of alcohol
• Body weight

Alcoholism & Depression

Drinking alcohol is often associated with a quick fix to help someone’s mood; however, constant alcohol consumption can bring on more depressed feelings. It also works against any antidepressants you may be currently taking, making the depression even worse. Depression is a risk factor for those who develop alcohol use disorder, and it is crucial to understand the link and risks that accompany both.¹⁰

Once someone is receiving successful treatment for depression, they may think it’s okay to drink alcohol as a reward, but this is not the case. It also may seem like alcohol can help remedy certain side effects from starting a new medication. But this can lead to worse side effects, not fewer side effects. Remember, alcohol can disrupt the medication to treat depression or anxiety and erase any progress made from treatment.⁸

Symptoms of an Overdose With Lexapro and Alcohol

Taking too much Lexapro or alcohol at once can be life-threatening. If you or someone taking Lexapro and drinking alcohol is experiencing severe side effects or an overdose, it is necessary to call 911 and get help right away. It is essential to stay with the person until help arrives. Recognizing the signs of harmful side effects is an integral part of safe treatment.

Symptoms of an overdose on Lexapro and alcohol may include:⁴

• Seizures or convulsions
• Unresponsive or in a coma
• Low blood pressure or feeling faint or dizzy
• Nausea or vomiting
• Fast heartbeat or change in heartbeat rhythm

When to Seek Professional Help

If you or someone you know is taking Lexapro and struggling with drinking alcohol, it is always best to seek help immediately. It is never too early to seek help, and your doctor is a great place to start. They can discuss treatment options or refer you to the proper care.

It is also essential to be open with your healthcare team. It is not safe to hide information about your risks of dependence or addiction that may be sensitive. The more information your care team has, the better they can help you.

Questions to Ask Your Health Team About Lexapro and Alcohol

Taking Lexapro comes with many risks, and understanding those risks is the first step to safe treatment. It is essential to ask your doctor the right questions before taking the medication. Those who don’t understand the dangers of drinking alcohol while taking Lexapro are at the highest risk for severe side effects.

The right time to bring up your current alcohol use is before starting treatment with Lexapro. You and your doctor can discuss how you might need to change your drinking habits to stay safe. Being honest with your doctor can help them decide if changing your drinking habits is required or if a different medication other than Lexapro is a better fit for you.

Questions to ask your care team include:

1. Is there a safe amount of alcohol that I can consume when taking Lexapro?
2. If someone wants to drink, should they stop taking Lexapro for the day?
3. Are there anxiety medications or depression medications that are not negatively affected by alcohol?
4. What should I do if I drink and have an adverse reaction?
5. Should I eat food while drinking alcohol?
6. Do I have to wait a certain amount to take Lexapro before drinking?
7. What reactions will I most likely have if I drink alcohol?

Final Thoughts

Drinking alcohol while taking Lexapro is not recommended. Alcohol can make side effects of Lexapro, like drowsiness and dizziness, worse. Alcohol can also work against Lexapro to increase feelings of depression.¹  Drinking alcohol greatly affects the brain and can change how Lexapro works, leading to dangerous side effects. Talking to your doctor, understanding the risks of drinking alcohol while taking Lexapro, and avoiding alcohol will keep you safe during treatment.