Last reviewed
Mixing alcohol with psychiatric medications: what to know
How alcohol interacts with antidepressants, anxiety and sleep medications, ADHD medications, mood stabilizers and more, and when the risks are serious.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Photos are illustrative and don’t show actual patients.
Most psychiatric medication labels say to avoid alcohol. For some medications, that warning is about feeling worse. For others, the combination can be dangerous. Here’s a general guide, and your prescriber can tell you what applies to you.
Benzodiazepines, sleep medications and opioids
Alcohol combined with medications like alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), zolpidem (Ambien), gabapentin, pregabalin or opioids can cause extreme sedation, blackouts and dangerously slowed breathing. This is the most serious combination.
Antidepressants (SSRIs and SNRIs)
A small amount of alcohol usually isn’t dangerous with these, but alcohol can increase drowsiness, worsen depression and anxiety, and make the medication work less well. Many people find they feel drunk faster.
Bupropion (Wellbutrin)
Heavy drinking, and suddenly stopping heavy drinking, can raise the risk of seizures while taking bupropion. Keep alcohol minimal and tell your prescriber how much you drink.
MAOIs
Some MAOIs interact with tyramine, found in certain tap beers and some wines, which can cause a sudden, dangerous rise in blood pressure. If you take an MAOI, follow your prescriber’s food and drink guidance closely.
Mood stabilizers and antipsychotics
Alcohol adds to the drowsiness from medications like quetiapine (Seroquel) and olanzapine. It can affect lithium levels through dehydration, and it adds strain on the liver with valproate.
ADHD stimulants
Stimulants can mask how drunk you feel, which can lead to drinking more than you realize. The combination also puts extra strain on the heart.
Be honest with your prescriber
There’s no judgment in telling your prescriber how much you really drink. It helps them choose safer medications and doses for you.
A gentle next step
Wellthy Psychiatry offers judgment-free, LGBTQ+ affirming care by telehealth across California. A free 15-minute phone consult is an easy way to see if we’re a good fit.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. His background includes inpatient psychiatry and community mental health at Glenn County Behavioral Health and Equity Health, a federally qualified health center. He sees clients in San Francisco and by telehealth across California.
Keep reading
Related posts
Sexual side effects of SSRIs: what’s common and what helps
Why SSRIs can affect desire, arousal and orgasm, how common it is, and practical options if it’s happening to you.
Antidepressants with fewer sexual side effects
A plain-language look at medications that tend to be easier on desire and orgasm, and the tradeoffs of each.
FDA approvals for common psychiatric medications: a quick guide
What common psychiatric medications are FDA-approved to treat, and why your prescription might not match the label.
Off-label prescribing in psychiatry: what it means and why it’s common
What “off-label” means, why psychiatric prescribers use it, common examples, and good questions to ask.