Can you drink alcohol while on Lexapro?

What is Lexapro?

Lexapro (escitalopram) is a kind of antidepressant called a selective serotonin reuptake inhibitor (SSRI), which increases the amount of serotonin available in your brain. Lexapro is approved to treat symptoms of depression and anxiety in adults and adolescents 12 and older, according to the FDA.

It’s often considered a first-line antidepressant treatment for major depressive disorder and generalized anxiety disorder, says Amy Werremeyer, Pharm.D., a professor at North Dakota State University’s department of pharmacy practice.

Unlike some other antidepressants, Lexapro doesn’t directly target any neurotransmitters other than serotonin receptors in your brain, says Jim Campasano, M.D., chief operating officer at Thriveworks, which could mean it has fewer side effects for some people.

Can you drink alcohol while on Lexapro?

The FDA recommends avoiding alcohol while using Lexapro, which is why you might notice a warning on the prescribing information that comes with your prescription. Though clinical trials for the drug didn’t show any adverse effects of mixing the two, Dr. Campasano and Dr. Werremeyer say you should proceed with caution.

What are the risks of combining Lexapro and alcohol?

While Lexapro won’t amplify the effects of alcohol (or vice versa), combining the two isn’t recommended for a few reasons. For starters, both alcohol and Lexapro can come with side effects like drowsiness and nausea on their own, which means that drinking with Lexapro could make side effects worse than they would be if you weren’t drinking, says Dr. Werremeyer.

But the primary risk of drinking while on Lexapro is that alcohol is known to increase the mental health symptoms that Lexapro is often prescribed to treat.

How alcohol impacts your mental health

Increased depression symptoms: Research shows that even moderate drinking is associated with worsening depression. One reason is that alcohol affects certain neurotransmitters that impact your mood, explains Dr. Werremeyer. When you drink, your brain releases more serotonin than it can use. This depletes how much is available overall. So when Lexapro tries to do its job, keeping the serotonin levels stable, there is less of the neurotransmitter to work with.

Those effects can compound over time. “The more someone uses alcohol, the harder it will be for their brain to regenerate serotonin,” Dr. Werremeyer says. The same is true of other neurochemicals involved in mood, she adds.

Increased anxiety symptoms: Alcohol can also worsen anxiety by disrupting the balance between two key brain chemicals. In the moment, alcohol boosts the effects of GABA (a neurotransmitter that calms brain activity) and dampens glutamate (which revs it up). That’s part of why a drink can feel relaxing. But the brain adapts to restore balance by releasing more glutamate to offset GABA activity coming from the presence of alcohol, explains Dr. Werremeyer. When the alcohol wears off, that leaves the brain in an overexcited state, which can show up as anxiety, restlessness, or the next-day dread sometimes called “hangxiety.” These effects tend to be more intense and longer-lasting with regular heavy drinking.

Disrupted sleep: Whether you’re taking an SSRI or not, drinking can mess with the quality of your rest by interfering with neurotransmitters that influence sleep, including GABA and glutamate. Larger amounts of alcohol disrupt your normal sleep patterns by making you fall asleep faster, delaying rapid eye movement (REM) sleep in the first half of the night, and increasing wakefulness in the second half. And we know that poor sleep can affect your mental health. For instance, a 2014 study of college students with depression symptoms found that those who also had sleep disturbances had worse anxiety and their physical and mental performance suffered.

The potential for misuse: People with anxiety or mood disorders may be more likely to misuse alcohol or even develop alcohol use disorder, per a 2023 study. Drinking can often be a way for people with anxiety or depression to self-soothe or “self-medicate,” says Dr. Campasano. So if you’re using Lexapro to manage an anxiety or mood disorder, it’s worth keeping this increased risk in mind.

Can you die from mixing Lexapro and alcohol?

While there are certainly risks of mixing Lexapro and alcohol, the risk of dying from this combination alone is unlikely. The main danger is that alcohol can interfere with your ability to manage the very mental health condition that Lexapro is prescribed to treat.

If you’re thinking of drinking while taking Lexapro, talk to your provider first. While drinking on an antidepressant always comes with a risk of worsening mental health symptoms, if your symptoms have been under control for three to six months and you know you can stop at one or two drinks, it’s probably OK to drink occasionally, Dr. Werremeyer says. But if you don’t meet either of those criteria, the risk of drinking on Lexapro is much higher.

If you do drink, monitor how you feel over the next day, week, or month. That data can tell you how much of an impact alcohol has on your mental health and other parts of your life. Every individual is different, says Dr. Werremeyer.

Why you shouldn’t skip Lexapro to drink

If you’re worried about mixing alcohol and Lexapro, you may have considered skipping your dose on days that you plan to have a drink. But experts strongly advise against this.

Some medications, like Lexapro, take time to reach their full therapeutic effect. So when you skip a dose, the amount of serotonin in your brain can fall fairly rapidly, which means that it’s much more difficult for your brain to sustain your mood and prevent symptoms, says Dr. Werremeyer.

Read more: How long does Lexapro take to work?

It could take days or weeks for the medication to get back to baseline in your system. “With an SSRI or an SNRI, it’s always safer to keep taking the antidepressant, even in the presence of alcohol,” she adds.

Skipping doses of Lexapro can also lead to antidepressant discontinuation syndrome, she adds. That can cause flu-like symptoms, like headache, body aches, and fatigue, as well as insomnia, nausea, dizziness, and mild but unpleasant sensory disturbances (also known as “brain zaps”).

The bottom line

If you’re taking a mental health medication like Lexapro, it likely means that your mental health symptoms are negatively impacting your life. And since we know that alcohol comes with a risk of worsening those symptoms, experts recommend abstaining.

Ultimately, if your desire to drink interferes with taking your medication as prescribed (or filling the prescription in the first place), it’s worth bringing that up to your mental health provider.