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HomeAddictionMixing Drugs & AlcoholLexapro and Alcohol
Lexapro And Alcohol

8 Minutes

Edited & medically reviewed by THE BALANCE Team
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Mental health disorders have shown a rising trend in the last three decades. The ever-increasing consumption of alcohol stands as a major factor in deteriorating mental health since it disrupts brain chemistry and triggers mood decline while escalating anxiety. 

Yet, seeking treatment for mental health disorders without ceasing alcohol use is a two-edged sword. For instance, the combination of alcohol with antidepressant medication such as Lexapro leads to stronger side effects [1]. When used together these substances create additional challenges for mental health management which might produce severe emotional and physical difficulties [2].

Lexapro is an antidepressant medicine that belongs to the selective serotonin reuptake inhibitor (SSRI) group of drugs. It is also known under the generic name escitalopram. Lexapro functions by enhancing serotonin in brain tissue which has an essential role in managing mental health in general and emotional balance in particular [3]. 

Lexapro helps regulate mood and keeps the patient calm and happy through its effects on serotonin neurotransmitter levels. People who have low serotonin levels tend to develop depression anxiety or mood conditions.

Escitalopram differs from other antidepressants because its targeted impact on serotonin leads to better biological tolerance. The medicine carries possible risks when used alongside alcohol because of its counteracting side effects.

Doctors use Lexapro to treat a variety of mental health disorders:

Major Depressive Disorder (MDD): The medication Lexapro treats MDD patients who experience long-term sadness combined with loss of interest and despair.

Social Anxiety Disorder (SAD): Doctors sometimes prescribe Lexapro to patients with SAD outside its approved uses. 

Obsessive Compulsive Disorder (OCD): Doctors use Lexapro off-label for OCD because it helps decrease intrusive thoughts even though the FDA has not approved it for this condition.

Panic Attacks: Lexapro also prevents unexpected panic attacks.

Doctors begin treatment with small amounts of Lexapro at 5mg or 10mg per day and make changes based on how well the body reacts. It takes a few weeks before Lexapro shows its full effects.

How Safe Is Alcohol Use With Lexapro 5mg And Other Stronger Doses?

People who take Lexapro ask frequently about alcohol use, especially at low doses of 5mg or 10mg. Lexapro affects brain function even in small amounts and alcohol can disrupt this effect. Some users may not notice significant changes in their health yet others will experience stronger side effects including dizziness and mental clouding [3].

Taking 15mg or 20mg of Lexapro makes alcohol have a stronger impact on your body. As stronger Lexapro doses stay in the system for a longer duration, so even occasional low-dose drinking can lead to unexpected outcomes. Doctors recommend patients stay away from alcohol completely during their Lexapro treatment period.

How Alcohol Affects Escitalopram In The Body

As a depressant substance, alcohol reduces central nervous system activity. Lexapro functions in the exact opposite manner to the intended function of Alcohol. The brain receives conflicting signals when Lexapro elevates serotonin levels since alcohol simultaneously decreases serotonin levels. 

This can result in:

  • Drinking alcohol tends to strengthen Lexapro’s sedative properties which results in severe tiredness and sleepiness [4].
  • Drinking alcohol opposes the beneficial anti-depressant and anxiolytic effects of Lexapro which leads to stronger reactionary symptoms of depression or anxiety.
  • The combination of Lexapro with alcohol raises the chances of experiencing memory problems and blackouts due to alcohol’s impact on brain cognitive abilities.

Short-Term Reactions To Alcohol And Lexapro

The combination of Lexapro and alcohol produces instant negative side effects that appear after only one or two drinks. The most frequent immediate impacts from Lexapro use include:

  • Drinking while taking Lexapro leads to intense sleepiness loss of balance and light-headedness.
  • The combination of Lexapro with alcohol weakens your ability to control movements and your reflexes which raises the possibility of dangerous accidents.
  • Some individuals report enhanced emotional sensitivity when they show sudden mood shifts together with increased irritability and spontaneous emotional reactions.
  • Users taking Lexapro often become intoxicated at a faster rate than normal when they consume any amount of alcohol [3].
  • The intensity of side effects depends on several factors such as body weight and metabolism and overall health status. 

Following a dose of Lexapro, it remains active in your body for a considerable time (sometimes as long as 6 days) which increases the possibility of unpredictable alcohol interactions long after the Lexapro dose.

Long-Term Risks Of Mixing Lexapro And Alcohol

Long-term use of Lexapro with alcohol consumption leads to multiple serious health consequences which include:

  • The combination of alcohol with Lexapro results in deteriorating depression symptoms and increased anxiety levels which may progress into prolonged severe depression and heightened anxiety [2].
  • The outcome of emotional instability from medication interaction sometimes leads users to consume alcohol more often which results in alcohol dependence risks.
  • The liver serves as the processing center for both Lexapro and alcohol medication. The liver becomes overloaded when a person drinks alcohol frequently while taking Lexapro which could result in permanent damage to the organ [1].
  • The combination of long-term alcohol use with Lexapro treatment may cause decreased medication sensitivity which leads to increased dosage requirements for maintaining mental health benefits.

Increased Depression And Anxiety Risks

The main danger of combining Lexapro with alcohol lies in its adverse effects on mental wellness. The intended purpose of Lexapro involves stabilizing mood and decreasing depression and anxiety symptoms yet alcohol produces opposite effects during long-term use. The initial relaxed feelings from drinking will transform into these effects in the long run:

  • The consumption of alcohol leads to decreased serotonin levels that potentially reverse the positive effects of Lexapro treatment [3].
  • Some people develop panic attacks combined with heightened nervousness after consuming alcohol.
  • The consumption of alcohol causes difficulties in emotional management which results in irregular mood changes and sudden impulsive actions.
  • Few individuals experience suicidal thoughts when alcohol intensifies depressive symptoms, especially among those who have severe depression [5].

Physical Symptoms And Health Complications

Physical consequences from combining Lexapro with alcohol create various health problems which include the following:

  • The consumption of alcohol together with Lexapro treatment leads to stomach distress which often results in nausea and digestive issues.
  • Some users who take Lexapro experience migraines and headaches following alcohol consumption.
  • Both alcohol and Lexapro affect heart function which can result in abnormal heart rhythms or elevated heart rates.
  • Memory blackouts and event recall difficulty become more likely when alcohol mixes with Lexapro.

Is Moderate Wine Consumption Acceptable?

Users of Lexapro frequently ask whether consuming limited amounts of wine provides better protection against adverse effects. Drinking in moderation compared to heavy alcohol consumption presents fewer harmful effects but antidepressant use makes alcohol consumption risky. 

A single serving of wine produces these negative effects:

  • Alcohol produces excessive sleepiness as well as fatigue that impairs attention span.
  • The medicine becomes less effective which results in varying degrees of mental health recovery.
  • Limited amounts of alcohol can still produce emotional instability in users.

Healthcare providers advise their patients to abstain entirely from alcohol consumption while using Lexapro. Drinking small amounts of wine occasionally remains an option but you need to monitor how your body reacts to the alcohol.

The Impact Of Various Alcohol Types On People Using Lexapro

The impact alcohol has on Lexapro depends on which alcoholic beverage a person consumes. Some key differences include:

  • Many people consider wine safer because of its lower alcohol content yet it might cause drowsiness together with mood swings.
  • Beer provides lower alcohol strength than liquor yet its regular consumption with Lexapro leads to stronger side effects.
  • Spirits (vodka, whiskey, rum, etc.) have high alcohol concentration and present the most substantial danger of enhancing the sedation effects of Lexapro, hence triggering unexpected emotional responses.

Medical Warnings And Official Guidelines

The medical authorities recommend total abstinence from alcohol consumption during Lexapro medication use. Health organizations including the FDA and National Institute on Alcohol Abuse and Alcoholism advise against consuming alcohol while taking Lexapro because it hinders the effectiveness of selective serotonin reuptake inhibition, causing reduced serotonin levels, an effect opposite to Lexapro’s mechanism.

According to medical guidelines:

  • The consumption of alcohol leads to the deterioration of depression alongside anxiety symptoms thus rendering Lexapro less effective in its intended function.
  • Operating machinery or driving becomes hazardous because alcohol use raises the risk of drowsiness, dizziness, reduced reaction time, and impaired judgment.
  • Long-term alcohol consumption can diminish Lexapro’s effectiveness so patients might need to increase their medication dosage or add new drugs to their regimen.
  • Alcohol and Lexapro combination affect each individual differently which makes it impossible for doctors to define a safe alcohol limit for patients taking this medication.

Safe Drinking Habits While On Lexapro

Medical experts advise the following safety measures for people who choose occasional drinking despite their medications:

  • People who cannot avoid alcohol consumption must practice responsible drinking by sticking to one small glass of wine, only occasionally.
  • Individuals should carefully notice changes in their mood and any feelings of dizziness or other unexpected side effects.
  • Patients should abstain from alcohol consumption before and during adjustments in Lexapro treatment.
  • Get medical advice about alcohol safety by consulting your doctor before drinking.

General Safe Limits Of Alcoholic Beverages

Doctors generally define moderate drinking as a maximum consumption [5]:

For Men: Two alcoholic beverages in a day 

For Women: One alcoholic drink in a day

The United States medical authorities provide drinking guidelines [5] which define one beverage as:

Whiskey: 1.5 oz of a 40% alcohol by volume

Wine: 5 oz of a 12% alcohol by volume

Beer: 12 oz of 5% alcohol by volume

1. Gandhi P, Healy D, Bozinoff N. Severe alcohol use disorder after initiation of selective serotonin reuptake inhibitor therapy. CMAJ. 2023 Oct 16;195(40):E1380-E1382. doi: 10.1503/cmaj.231015. PMID: 37844929; PMCID: PMC10581713. https://pmc.ncbi.nlm.nih.gov/articles/PMC10581713/

2. Wood E, Rehm J; Canadian Alcohol Use Disorder Guideline Committee. Addressing the risks of antidepressants among people with alcohol use disorders. CMAJ. 2024 Mar 17;196(10):E349-E350. doi: 10.1503/cmaj.150095-l. Erratum in: CMAJ. 2024 Jul 14;196(25):E884. doi: 10.1503/cmaj.240910. PMID: 38499304; PMCID: PMC10948179. https://pmc.ncbi.nlm.nih.gov/articles/PMC10948179/

3. Medical News Today. Is it safe to drink alcohol while taking Lexapro? https://www.medicalnewstoday.com/articles/322569

4. Web MD. Lexapro and Alcohol: Risks, Effects, and Safety Tips. https://www.webmd.com/depression/lexapro-alcohol

5. U.S. Centers For Disease Control And Prevention. Moderate Alcohol Use. https://www.cdc.gov/alcohol/about-alcohol-use/moderate-alcohol-use.html

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