Prozac & Alcohol: Understanding the Risks

What Is Prozac (Fluoxetine)?

Prozac, the brand name of the generic drug fluoxetine, is FDA-approved for the treatment of depression and other mental health conditions. It belongs to the selective serotonin reuptake inhibitors (SSRIs) class of drugs that works by inhibiting the uptake of the neurotransmitter serotonin in the brain.² This can lead to improved moods and behaviors.³

Prozac is FDA-approved to treat:

• Bulimia nervosa
• Depression
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Treatment-resistant depression (when combined with olanzapine)
• Treatment of depression related to Bipolar I Disorder (when combined with olanzapine)

Those prescribed Prozac for depression typically experience increased relaxation and decreased anxiety. They may notice improvement in sleep quality, energy levels, and focus. Prozac works to increase serotonin levels in the brain, as studies suggest that serotonin plays an essential role in influencing one’s mood, emotions, behaviors, and sleep quality.² However, Prozac can result in side effects. Therefore, it is necessary to consult with your doctor before starting a prescription.

Side Effects of Alcohol & Prozac

Just like any other antidepressant, a Prozac prescription poses risk for adverse reactions in users. These can be mild or severe, depending on an individual’s health and genetic profile. When mixed with alcohol, severe side effects of Prozac can worsen. This is because alcohol is a depressant, while Prozac is an antidepressant. Therefore, combining the two can trigger or worsen each substance’s side effects.

Combining Prozac and alcohol can lead to increased sedation, as both substances can interfere with the central nervous system. In turn, a person will experience impacts in alertness and coordinated motion. Additionally, drowsiness can result from hangover anxiety (hangxiety), which occurs as a result of the consumption of substantial amounts of alcohol. This effect can lead to dangerous results such as poor decision-making, impaired judgment, and increased risks of falls and injuries.³

Side effects of Prozac may include:

• Lack of coordination
• Sleeping problems
• Drowsiness
• Low blood pressure
• Liver damage
• Headache
• Loss of appetite
• Nausea
• Diarrhea
• Dizziness
• Sweating
• Anxiety

Side effects of alcohol may include:

• Vomiting
• Loss of consciousness
• Blackouts
• Alcohol poisoning
• Mood swings
• Coma
• Seizures
• Risky behaviors
• Death

Prozac & Alcohol Interactions

Both Prozac and alcohol work differently in the brain and each substance carries with it its own side effects. Therefore, mixing Prozac and alcohol can increase the side effects of either substance. If you have been taking Prozac for a while, drinking can lead to exhaustion which can severely affect your judgment and motor skills.⁴

Side effects of mixing Prozac and alcohol may include:

• Impaired judgment: Antidepressants can help improve one’s cognition and memory. However, mixing alcohol and Prozac can interfere with the drug’s efficacy.⁵
• Anxiety: Mixing alcohol with Prozac can worsen symptoms of anxiety.
• Depression: Prozac is commonly used to treat depression. Alcohol, on the other hand, is a depressant that affects the brain’s natural serotonin levels. Therefore, consuming alcohol with Prozac can worsen symptoms of depression.
• Hearing problems: Prozac may result in sensorineural hearing loss.⁶ Alcohol affects inner ear hair cells which in turn can result in hearing loss. Mixing these two substances can worsen these effects. These problems were not shown in clinical trials with Prozac, but have been noted in small studies.
• Vision problems: Alcohol dilates blood vessels in a person’s eyes, damaging the optic nerve. Prozac also dilates these blood vessels which can cause vision problems or glaucoma in individuals who have or have not not had a history of glaucoma.⁷

Can You Ever Drink While Taking Prozac?

Consuming alcohol while on Prozac medication can lead to undesirable results. Thus, alcohol should be avoided for those who are prescribed Prozac. It’s important to remember that Prozac has a half-life of between four and six days. This means it takes time for its active ingredients to leave your system entirely. Therefore, if you stop taking your Prozac medication and consume alcohol shortly after, there is a high chance you will still experience adverse reactions and worsened symptoms.

Even when prescribed a smaller dosage of Prozac (20mg), mixing alcohol with the drug is not recommended. Do not suddenly discontinue your Prozac medication, as it may lead to severe and life-threatening side effects. While this antidepressant is not considered addictive, it is possible to develop a psychological dependence on it. This can result in withdrawal symptoms, worsening the effects of both Prozac and alcohol. You should talk with your doctor about when it is safe to drink alcohol after you have stopped taking Prozac.

Prozac withdrawal symptoms include:⁸

• Confusion
• Mood swings
• Agitation
• Anxiety
• Headaches

Can Mixing Prozac & Alcohol Kill You?

Both alcohol and Prozac work differently in the body, and their interaction can greatly impact your overall well-being. Furthermore, combining alcohol with Prozac can lead to a lethal overdose depending on individual factors such as sex, height, weight, age, and tolerance level. Binge drinking (consuming large amounts of alcohol in a single session) increases the chances of overdose.⁹ Overdose occurs as a result of the metabolization of alcohol in the body before that of Prozac, leaving the drug in one’s system for longer. Therefore, dangerous levels of Prozac remain present in an individual’s body, which may lead to overdose and sudden death.

Symptoms of a Prozac & Alcohol Overdose

A person will likely experience an overdose when they combine alcohol and Prozac. If you have symptoms of an overdose, you should call 9-1-1 for emergency medical assistance or visit the nearest emergency immediately.

Symptoms of a Prozac and alcohol overdose may include:

• Breathing difficulties
• Trouble speaking
• Impaired coordination and balance
• Seizures
• Tremors
• Drowsiness
• Agitation
• Vomiting

Questions to Ask Your Health Team

Prozac should be taken as prescribed by a medical professional. Discontinuing Prozac medication can lead to negative side effects that can greatly impact your life and wellbeing. If you are considering ceasing your Prozac dosage in order to consume alcohol, contact your doctor immediately to review possible adverse effects. If you are not aware of the risks of Prozac withdrawal, you are putting yourself in danger of severe health implications..

Questions to ask your care team include:

• Is there a safe amount of alcohol that I can consume when taking Prozac?
• Is there an alternative medication I can take that will not be negatively affected by alcohol?
• What should I do if I drink and have an adverse reaction?
• What are the early warning signs of overdose I should watch out for?
• I stopped my medication to drink. Should I continue with my medication as usual?

Final Thoughts

How a person reacts to the combination of Prozac and alcohol varies depending on their individual genetic makeup. However, mixing these substances can lead to severe adverse effects. Before you consider mixing alcohol with Prozac, consult with your medical provider to understand the potential risks.