Combining alcohol with SSRIs can also amplify the medication’s side effects and intensify sensations such as drowsiness, fatigue or dizziness, she added. “I’ve had patients who said one drink feels more like two. Alcohol might hit you harder, and not in that pleasant euphoric way, but in that tired mopey way.”
Consuming more than is recommended by the current US dietary guidelines for alcohol — two drinks or less per day for men, one drink or less per day for women — might interfere with your goals of improving your depression or anxiety symptoms, Dr. Andrews said.
As of now, there isn’t much evidence, if any, that an occasional drink while on SSRIs can cause harm. But we know less about how regularly drinking more than recommended amounts can affect you in the long run — a subject that needs more research, Dr. Glance said.
The idea that you shouldn’t mix alcohol with antidepressants comes from past research on older antidepressants that are now prescribed less frequently. “The message of, ‘Don’t drink while taking an antidepressant,’ is based on the odds of an increase in sedation, but this was based on older medicines like tricyclic antidepressants,” Dr. Glance said.
People who can’t take — or who aren’t benefiting from — SSRIs might still be prescribed tricyclic antidepressants or other classes of antidepressant drugs that may interact with alcohol. Drinking on monoamine oxidase inhibitor antidepressants (or MAOIs), for instance, can lead to dangerous spikes in heart rate and blood pressure that could require hospitalization, Dr. Glance said. “If you’re taking an MAOI, you shouldn’t be drinking alcohol at all.”
Another commonly prescribed antidepressant called bupropion (Wellbutrin) can potentially increase the risk of seizures when combined with too much alcohol.
In the end, Dr. Glance said, the best advice to follow is the same for any medication you might be taking: “Know what class of medication you’re taking, and talk to your doctor about alcohol use.”
Jyoti Madhusoodanan is an independent journalist based in Portland, Ore.