Key Takeaways
- Lexapro's prescribing label explicitly recommends avoiding alcohol while taking the medication.
- Both Lexapro and alcohol affect serotonin and the central nervous system, and combining them amplifies side effects like drowsiness, dizziness, and impaired judgment.
- Alcohol can reduce Lexapro's therapeutic effectiveness, potentially worsening depression and anxiety symptoms.
- Mixing alcohol and SSRIs increases the risk of serotonin syndrome, a rare but potentially fatal condition.
- People taking Lexapro often report feeling intoxicated more quickly and experiencing worse hangovers.
- If you find it difficult to avoid alcohol while on Lexapro, this may indicate a co-occurring alcohol use disorder that needs professional attention.
Can You Safely Drink on Lexapro?
The short answer: it is not recommended. The manufacturer of Lexapro (Forest Pharmaceuticals) and the FDA both advise against drinking alcohol while taking escitalopram. While an occasional drink may not cause a medical emergency for every individual, the combination carries real risks that increase with the amount of alcohol consumed.
How Lexapro and Alcohol Interact
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor that increases serotonin levels in the brain. Alcohol also temporarily increases serotonin activity before causing a rebound decrease. When combined:
- Amplified CNS depression: Both substances slow brain activity. Together, they produce enhanced drowsiness, slowed reaction times, and impaired motor function.
- Mood destabilization: Alcohol's serotonin effects can interfere with Lexapro's ability to maintain stable serotonin levels.
- Reduced medication effectiveness: Regular drinking can make depression and anxiety harder to treat, potentially leading to unnecessary dose increases.
- Serotonin syndrome risk: While rare, excessive serotonin activity from the combination can cause agitation, high body temperature, rapid heart rate, muscle twitching, and seizures.
What Could Happen If You Drink on Lexapro?
Common effects include:
- Feeling drunk faster than usual (lower alcohol tolerance)
- Increased drowsiness and fatigue
- Worsened anxiety the day after drinking
- Emotional instability — crying, anger, or panic
- Nausea and dizziness
- Impaired coordination and increased fall risk
- Blackouts at lower alcohol amounts
- Worsened depressive symptoms in the days following drinking
What Doctors Typically Advise
Most psychiatrists and primary care physicians recommend one of these approaches:
- Complete abstinence from alcohol while taking Lexapro (safest approach)
- Strict moderation — no more than one drink on rare occasions, with careful self-monitoring
- Trial approach — have a single drink in a safe environment and observe your reaction before considering further alcohol use
No physician will recommend regular or heavy drinking while on an SSRI.
If you or a loved one is facing these challenges, learn more about alcohol addiction treatment for those on antidepressants available at Trailhead Treatment Center in Salem, NH.
When the Combination Signals a Deeper Issue
If you find yourself unable to stop drinking despite knowing the risks of combining alcohol with your medication, this is an important warning sign. Co-occurring alcohol use disorder and depression is extremely common — approximately one-third of people with depression also struggle with alcohol.
Effective treatment for this dual diagnosis requires addressing both conditions simultaneously through integrated programs that combine mental health treatment with substance abuse care.
Trailhead Treatment Center provides dual diagnosis treatment for depression and alcohol use to support lasting recovery and wellness.
Conclusion
While not everyone who has a single drink on Lexapro will experience a medical emergency, the combination is medically discouraged due to the risk of enhanced side effects, reduced medication efficacy, and potential serotonin interactions. If alcohol use is complicating your mental health treatment, Trailhead Treatment Center offers dual diagnosis programs designed to help.