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For some individuals, medications like Lexapro are part of a daily routine to treat their depression. You take the same dose at the same time each day according to prescription instructions. Sometimes, it’s easy to overlook possible interactions with other substances, but that’s one reason that mixing alcohol and Lexapro can be dangerous.
For example, you are invited to a happy hour after work for a few drinks. You accept the invitation, have a few drinks and experience unexpected negative symptoms. You may think they are related to intoxication from alcohol, but these symptoms may be due to a negative interaction between Lexapro and alcohol.
What Happens When You Mix Lexapro and Alcohol?
Lexapro is a selective serotonin reuptake inhibitor (SSRI). This means that it increases the level of serotonin in your brain, lifting your mood. It excites the circuitry in the brain, unlike alcohol, which sedates brain circuitry.
Alcohol is a central nervous system depressant. Drinking alcohol impairs everything you do because it slows down brain activity, hindering decision making, speaking, walking and functioning.
Alcohol interferes with serotonin receptors, even when consumed in small amounts. Researchers have found that SSRIs and alcohol change the brain in similar ways by releasing serotonin into the brain’s reward system.
However, due to the unnaturally high level of brain activation produced when an SSRI is combined with alcohol. This feeling of profound euphoria can encourage an individual to continue mixing drugs and alcohol. The more someone uses substances over time, the more likely they are to develop a substance use disorder.
Side Effects of Mixing Lexapro and Alcohol
Misusing Lexapro alone can put you at risk for serotonin syndrome, cardiac problems and withdrawal syndrome.
Serotonin syndrome is a potentially life threatening condition that can happen as a result of taking too much medicine or interactions between Lexapro and recreational substances like alcohol. Symptoms include altered mental status, autonomic dysfunction, neuromuscular excitation, tremors or shakes, gastrointestinal problems and psychiatric illness.
Misusing alcohol alone carries risks like alcohol related blackouts and accidents and injuries from falling, tripping or loss of motor skills.
Alcohol causes slowed reactions that can be life threatening when completing tasks like driving or operating heavy equipment. Long term misuse of alcohol can negatively impact vital organs, leading to liver and heart disease and cancers, including breast, colorectal and liver cancer.
Alcohol affects judgment and decision-making skills that can contribute to high risk behavior, such as unprotected sex or using alcohol with other substances.
The National Institute on Alcohol Abuse and Alcoholism reports that potential side effects of mixing Lexapro with alcohol include increased:
- Drowsiness
- Dizziness
- Disorientation and confusion
- Impaired motor skills
- Risk for overdose
- Feelings of depression or hopelessness
- Alcohol effects
Mixing substances can also cause gastrointestinal bleeding, fluctuations in blood pressure, convulsions or seizures, and heart rhythm disturbances.
What Are the Dangers of Misusing Lexapro and Alcohol?
Using alcohol while on an SSRI can make your antidepressants ineffective, increasing your depressive symptoms. These symptoms may be severe immediately after alcohol use, especially during periods of hangover or alcohol withdrawal.
Misusing antidepressants includes any intentional use of Lexapro that does not comply with your prescription for any reason. For example, taking more Lexapro than prescribed, taking someone else’s medicine or mixing Lexapro and alcohol. Varied reactions can occur.
For some, mixing Lexapro and alcohol can create stimulant like effects or euphoria. Over time, the effects change. To achieve that initial feeling of reward, you may increase the amount you consume.
The technical term for mixing alcohol with Lexapro or misusing two or more substances is polysubstance misuse, which can lead to polysubstance use disorder and puts you at a higher risk for negative outcomes.
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When an individual takes medication and uses substances like alcohol for long periods, they develop tolerance. Tolerance is the need to use more of a substance to achieve the same effect you did when you first started taking it.
As your tolerance becomes higher, you will notice specific symptoms appear when you try to stop drinking, reduce the amount you use or do not have access to antidepressants or alcohol.
These are called withdrawal symptoms, signs your body has become dependent on Lexapro and alcohol in your system and needs them to function. Many people continue to misuse drugs and alcohol to avoid polysubstance withdrawal.
Polysubstance Withdrawal
Anyone who misuses alcohol and antidepressants can experience withdrawal symptoms. Factors such as age, weight, duration of use and the amount of substance used play a role in withdrawal symptoms.
Symptoms of alcohol withdrawal can range from mild to severe and may include:
- Hand tremor
- Insomnia
- Agitation
- Delusions
- Seizures
- Hallucinations
- Elevated blood pressure
- Delirium
- Paranoid ideas
- Anxiety
- Nausea, vomiting
You can also experience withdrawal symptoms from Lexapro. This is especially true if you suddenly stop taking your medication. These symptoms, also called antidepressant discontinuation syndrome, can also range from mild to severe.
Reports of withdrawal symptoms from antidepressants like Lexapro include:
- Flu like symptoms such as fatigue, achiness, headache and sweating
- Vivid dreams or nightmares
- Nausea and sometimes vomiting
- Paresthesia or shock like sensations, burning or tingling of the skin.
- Anxiety
- Irritability
- Agitation
- Anger outbursts
How Is Polysubstance Use Disorder Treated?
All substance misuse and addiction treatment begins with an extensive assessment by a licensed mental health or drug and alcohol addiction professional.
During the evaluation, you will review risk factors for polysubstance use disorder, including:
- Family history of substance misuse: Family history can indicate a possible genetic influence that contributed to the development of depressive symptoms or substance misuse.
- As well as being exposed to substance misuse while growing up can increase your risk.
- Underlying medical and psychological conditions: Some people who have medical or behavioral conditions may develop substance use disorders as a secondary condition as they attempt to self manage and alleviate their physical or mental symptoms.
- Unprocessed personal traumas or stressors: Certain experiences, such as surviving a natural disaster, accidents or assault, are associated with an increased risk of depressive symptoms and potential development of substance use disorder.
- Your treatment plan may include trauma informed therapy to address these contributing factors.
- Home environment and social circle: Where you live and who you have to support you can contribute to the social aspects of addiction and recovery.
It’s important to note that having any or all of these risk factors does not predict, dictate or guarantee the development of substance misuse or addiction. Your clinician will use this information to understand which needs you may have in recovery.
For example, if you had a history of alcohol misuse before you received a depression diagnosis, this may inform the treatment approach. The results from your assessment will be used to create your own unique and individualized treatment plan, because there is no one-size-fits-all polysubstance use disorder.
Detox
If you experience extremely uncomfortable or medically significant withdrawal symptoms when you stop using alcohol or if it is not safe for you to stop taking Lexapro suddenly, detox may be indicated.
Your doctor will decide if you should transition to another antidepressant, mood stabilizer, or other medication to manage your depressive symptoms in addiction treatment without Lexapro.
Once detox is complete, you can transition to inpatient rehab for ongoing medication management and therapy.
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During inpatient rehab, you will attend education and therapeutic groups to learn the necessary skills to stay sober after leaving treatment.
Early recovery, relapse prevention, self care, communication and conflict resolution are examples of the skills you can learn. You may also participate in individual and family counseling, 12-step groups or complementary holistic interventions.
Outpatient Programs
Intensive outpatient programs or partial hospitalization programs allow you to meet with group and individual supports several times per week while receiving intensive treatment. During outpatient treatment, you can take care of your family responsibilities and work or attend school while also getting the much-needed support to maintain recovery.
Aftercare
Before you leave inpatient rehab or complete an outpatient program, you will create an aftercare plan with your counselor. Aftercare plans may include staying at a sober living residence before transitioning home.
Sober living homes give you the chance to practice the skills you learned while in inpatient treatment before you go home. You live with peers who are also in early recovery, and you support one another while also participating in your community.
You may also receive assistance with education or employment goals, such as applying for vocational programs or going to job interviews. During this time, you can connect with social support groups, like Alcoholics Anonymous (AA), as well as other mental health support groups.
If you are using Lexapro and alcohol together, you may recognize some of the symptoms listed above. If so, we can help. Even if you are not experiencing symptoms but want to stop mixing alcohol and drugs, there are treatment options.
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Cary brings over three decades of nursing expertise as an LPN and holds a Bachelor’s degree in Liberal Arts. She is also working towards a Master’s degree focused on public health policy. Her professional journey has been dedicated to addressing healthcare disparities for both adults and children.
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