Dangers of Lexapro Use and Alcoholism

Medication-Assisted Treatment can cause problems for at risk populations

Lexapro, or brand name escitalopram oxalate, is an antidepressant and antianxiety. Lexapro is an SSRI and prescribed to treat generalized anxiety disorder, major depressive disorder, and other mental health issues.

Lexapro affects the brain by blocking the reuptake of serotonin. Serotonin is a neurotransmitter which affects mood. SSRI drugs are known as one of the safest classes of antidepressants, and are typically a health care providers first choice for treating depressive disorders [3].

Dangers of Combining Lexapro With Alcohol

Although not definitive, it is imperative to avoid combining antidepressants, or Lexapro, and alcohol. Alcohol can worsen the depressive symptoms, such as increased anxiety or depression [3].

Alcohol can counteract the benefits of antidepressants and make symptoms more difficult to treat. Alcohol can give the illusion that mood is improved short term, but overall the effect increases symptoms of anxiety and depression.

If an individual is taking additional medications, mixing Lexapro and alcohol can worsen symptoms of multiple issues. Judgement and reason are also impaired when combining alcohol and Lexapro.

Coordination, reaction time and ability to complete daily tasks and activities are also affected. A person may also feel sedated or drowsy [1]. It is important to note that it is not recommended that a person stops taking their antidepressant to drink. Prescribed antidepressants require consistent, daily doses to maintain constant levels in mood and stabilization [1].

Combining alcohol with Lexapro can significantly impact individuals. Drinking alcohol while on Lexapro may cause decreased efficacy of the medication, increased anxiety, worsen depressive symptoms, increase drowsiness, liver problems, and alcoholism [3].

Alcohol may also increase the risk of Lexapro related side effects, to include, nausea, insomnia, sleepiness, dry mouth, and diarrhea [3]. Lexapro can also increase the risk of suicide, and is especially high in children, teens, and young adults [3].

These Lexapro induced symptoms can also occur in the first few months of antidepressant treatment when dosages are changing/increasing, and symptoms are not yet stabilized.

Understanding Potential Interactions

Face in the shadowsInteractions of Lexapro and alcohol can alter the metabolism as well as the activity of the medicine [4]. This can result in serious medical consequences. Both substances are sedatives and when taken together, can enhance each other, therefore affecting one’s ability to drive or necessary tasks that put oneself or others in danger.

When alcohol is ingested, a small amount is immediately metabolized in the stomach. The remaining amount is absorbed into the bloodstream and GI tract, primarily the stomach and upper small intestine.

The liver is the primary site of alcohol metabolism and alcohol that is circulating in the blood is transported to the liver, which is broken down by ADH and cytochrome P450 [4]. ADH converts alcohol into acetaldehyde or oxidized which is toxic and contributes to many of alcohol’s adverse effects [4].

There are two types of interactions that can occur with alcohol-medication interactions. The first is pharmacokinetic and the second pharmacodynamic. Pharmacokinetic are those interactions where the presence of alcohol directly interferes with the normal absorption of the medication.

It can take two forms, the first being the breakdown and excretion of the medication is delayed because the medications compete with the alcohol for breakdown by the enzyme cytochrome P450 [4]. Secondly, the metabolism speeds up the absorption of the medication due to the fact that alcohol enhances the activity of medication-metabolism cytochromes.

Therefore the medication is burned off faster in the body. The interactions between alcohol and medications occur in the central nervous system and alcohol alters the effects of the medication 4].

The second type of interaction, Pharmacodynamic is when alcohol-medication interactions do not involve enzyme inhibition or activation, but are due to the additive effects of alcohol with medications.

Man on the beachThe interaction occurs primarily in the central nervous system and alcohol will alter the effect of the medication without changing the medication concentration in the blood. With antidepressants, the alcohol enhances the sedative effects [4].

Antidepressants have various classifications which all differ in their mechanism of action in how they affect the brain chemicals. Lexapro which is an SSRI, will combine with alcohol to increase sedative effects, is the least serious of interactions that can occur with occasional alcohol doses [4].

Identifying Risks and Seeking Help

Clinical trials not show with certainty that alcohol increases the effects of Lexapro on the brain. There is still risk in combining both Lexapro and alcohol, but it can increase serious side effects. If a person does drink, it is best to talk with a healthcare provider to discuss safe alcohol consumption rates.

There are side effects that can occur with combining lexapro and alcohol, which are decreased efficacy of the medication, increased anxiety, worsened depression, drowsiness, liver problems, and increased risk for alcoholism. Alcohol can also increase the risk for Lexapro related side effects such as nausea, insomnia, sleepiness, dry mouth, and diarrhea [3].

Lexapro is an SSRI and helps restore chemical balance to the brain to combat depression and anxiety, and works in the central nervous system. Alcohol also acts as an active agent in the form of a depressant in the central nervous system, and alcohol directly interacts with Lexapro and alters it effects [5].

According to healthcare providers, it is recommended that individuals on Lexapro limit alcohol intake due to the fact that it affects both the medication and alcohol, to include drowsiness, dizziness and abdominal distress. In extreme cases, Lexapro and alcohol combined together can cause seizures and death [5].

Man sittingIn conclusion, even though it is not yet certain that Lexapro and alcohol when combined are dangerous, it is known that their combination is not advised and is risky behavior.

The sedative effects when combined, can be lethal to both the individual and others if chose to drive or other at risk behaviors.

Talking with a healthcare provider prior to starting Lexapro about the cautions of combining SSRI’s with alcohol, or concerns of alcoholism, is important for being prescribed anti-depressant or anti-anxiety medication.

If someone is struggling with an addiction, it is important to seek help through a drug rehab facility or mental health provider.

Community Discussion – Share Your Thoughts here!

What do you think increases risks for abusing alcohol when taking prescription medications?

Image of Libby Lyons and familyAbout the Author: Libby Lyons, MSW, LCSW, CEDS, is a Certified Eating Disorder Specialist (CEDS) who works with individuals and families in the area of eating disorders. Mrs. Lyons works in the metropolitan St. Louis area and has been practicing in the field for 11 years. Libby is also trained in Family Based Therapy (FBT) to work with children-young adults to treat eating disorders. Mrs. Lyons has prior experience working with the United States Air Force, Saint Louis University, Operating Officer of a Private Practice, and currently works with both Saint Louis Behavioral Medicine Institute within their Eating Disorders Program and Fontbonne University


[1]: http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants-and-alcohol/faq-20058231
[2]: https://pubs.niaaa.nih.gov/publications/Medicine/medicine.htm
[3]: http://www.healthline.com/health/depression/lexapro-and-alcohol#Introduction1
[4]: https://pubs.niaaa.nih.gov/publications/arh23-1/40-54.pdf
[5]: http://www.drugsdb.com/rx/lexapro/lexapro-and-alcohol/

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Reviewed By: Jacquelyn Ekern, MS, LPC on January 18, 2017.
Published on AddictionHope.com

About Jacquelyn Ekern, MS, LPC

Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Many of the eating disorder sufferers that contact Eating Disorder Hope also had a co-occurring issue of addiction to alcohol, drugs, and process addictions.