Navigating Mental Health: Lexapro, Alcohol, and Your Well-Being

Taking charge of your mental health is a powerful step forward. If you've recently started taking Lexapro for anxiety or depression, you might be noticing positive changes—like feeling more relaxed and rediscovering joy in daily activities. Naturally, you may want to celebrate this progress by socializing with friends, which might lead to the question: Is it safe to drink alcohol while on Lexapro?

This article explains why mixing Lexapro and alcohol can worsen anxiety and depression symptoms. We'll explore the science behind their interaction and outline the potential risks.

Understanding Anxiety and Depression

Mental health conditions are common, affecting about 1 in 4 people. Anxiety and depression are among the most widespread:

• Nearly 18% of people in the U.S. have a diagnosed anxiety disorder.
• About 9.5% have been diagnosed with depression.

Anxiety is a natural response to stress or danger, but it becomes problematic when worry is excessive, persistent, and hard to control. Common anxiety disorders include generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, and specific phobias. Shared symptoms include restlessness, muscle tension, irritability, sleep issues, and difficulty concentrating.

Depression, on the other hand, involves persistent feelings of sadness, hopelessness, and emptiness. It goes beyond normal mood fluctuations. Common depressive disorders include major depressive disorder (MDD), persistent depressive disorder, bipolar disorder, and seasonal affective disorder (SAD). Symptoms may include loss of interest in activities, changes in appetite or sleep, fatigue, and thoughts of death or suicide. A diagnosis typically requires these symptoms to last at least two weeks and interfere with daily life.

Both anxiety and depression are linked to low levels of serotonin, a key neurotransmitter that helps regulate mood. Other brain chemicals, like dopamine and GABA, also play a role.

How Lexapro Helps

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder and generalized anxiety disorder. It works by increasing serotonin levels in the brain.

Here’s how it works: Serotonin is released into the synapses (gaps between brain cells). Normally, unused serotonin is reabsorbed. Lexapro blocks this reuptake process, leaving more serotonin available to improve mood and reduce anxiety.

Like all medications, Lexapro can cause side effects. Common ones include:

• Nausea
• Headaches
• Dry mouth
• Sleepiness or drowsiness
• Insomnia
• Fatigue
• Changes in appetite
• Sweating
• Decreased sex drive

Most side effects fade within a few weeks. However, if you experience serious symptoms like seizures, irregular heartbeat, or confusion, seek medical help immediately.

Alcohol’s Impact on Mental Health

Alcohol is a depressant. It may initially produce feelings of relaxation and euphoria, but it often intensifies anxiety, sadness, and irritability afterward. Long-term use increases the risk of developing or worsening anxiety and depression.

Alcohol affects brain chemistry by increasing GABA (an inhibitory neurotransmitter) and temporarily boosting dopamine and serotonin. Over time, however, it disrupts the balance of these chemicals, leading to lower levels and worsening mental health symptoms.

What Happens When You Mix Lexapro and Alcohol?

Both Lexapro and alcohol influence serotonin. Combining them can amplify side effects, such as:

• Drowsiness
• Nausea
• Low energy
• Headaches
• Poor coordination
• Memory problems

These effects can be more intense when Lexapro and alcohol are used together.

Risks of Combining Lexapro and Alcohol

Mixing Lexapro and alcohol carries several risks:

• Liver damage: Both substances are processed by the liver, and combining them increases strain on this organ.
• Serotonin syndrome: A rare but serious condition caused by excessive serotonin. Symptoms include confusion, fever, tremors, and rapid heart rate. Seek emergency care if these occur.
• Worsened anxiety or depression: Alcohol can counteract Lexapro’s benefits and intensify symptoms.
• Suicidal thoughts: Some people may experience these when mixing the two. If you have suicidal thoughts, call 988 or seek immediate help.
• Alcohol dependence: Research suggests that SSRIs may increase alcohol cravings and the risk of dependence.

Can You Drink on Lexapro?

Most doctors advise avoiding alcohol while taking Lexapro. If your symptoms are well-controlled, an occasional drink might not cause immediate harm—but always check with your healthcare provider first. If you do drink, practice moderation: limit intake, drink slowly, and eat beforehand.

Never skip a dose of Lexapro to drink alcohol. Stopping abruptly can cause withdrawal symptoms like increased anxiety, dizziness, nausea, and "brain zaps." Always consult your doctor before making any changes to your medication.

Alcohol-Free Alternatives

If you and your doctor decide it’s best to avoid alcohol, consider these enjoyable alternatives:

• Try a new mocktail or non-alcoholic beer.
• Enjoy a specialty tea while reading or watching a favorite show.
• Plan a sober activity with friends, like hiking or visiting a coffee shop.
• Use Quitemate to help reduce or quit alcohol.