Are People More Depressed Than Ever?

It's a question worth asking, especially since antidepressant prescriptions have surged in recent years—particularly during the COVID-19 pandemic. But even before the pandemic, 1 in 8 American adults was already taking an antidepressant. One estimate shows that number jumped by 18.6% in 2020.

Like any medication, antidepressants come with important considerations, such as side effects and potential interactions. One key area to understand is how alcohol affects antidepressants. Drinking while on these medications can raise the risk of side effects and may even worsen depression.

How Antidepressants Work

Antidepressants boost levels of naturally occurring brain chemicals called neurotransmitters, which help transmit signals between nerve cells and influence mood, thoughts, and emotions.

The most common type is selective serotonin reuptake inhibitors (SSRIs). These increase serotonin—a neurotransmitter that helps regulate mood, sleep, and emotion. Normally, serotonin is reabsorbed by nerve cells after delivering a message. SSRIs block this reabsorption, leaving more serotonin available to send further messages.

Zoloft (sertraline) is one of the most widely prescribed SSRIs and ranks as the 12th most commonly prescribed medication in the United States.

Mixing Alcohol and Antidepressants

Alcohol affects the central nervous system (CNS), which includes the brain and spinal cord. This leads to drowsiness, slurred speech, and the feeling of being drunk. Since SSRIs also act on the CNS by increasing serotonin, combining them with alcohol can intensify side effects.

Common antidepressant side effects include:

• Drowsiness
• Dizziness
• Nausea or vomiting
• Diarrhea
• Decreased libido

When alcohol is added, these effects can become more severe. Thinking, coordination, and reaction time may also be more impaired than with alcohol alone.

Other types of antidepressants carry additional risks:

• MAOIs (e.g., Azilect, Eldepryl): Mixing with alcohol can cause dangerous blood pressure spikes.
• SNRIs: May increase risk of liver damage.
• TCAs (e.g., Elavil, Anafranil): Can heighten intoxication.
• Atypical antidepressants (e.g., Wellbutrin): May raise seizure risk.

Alcohol Can Worsen Depression

Alcohol is a depressant that alters brain chemistry and can deepen feelings of depression. Drinking while on antidepressants may reduce the medication's effectiveness.

SSRIs also carry a risk of increasing suicidal thoughts, especially in people under 25. Since alcohol impairs judgment, combining the two can be especially dangerous for someone already experiencing such thoughts.

While alcohol might temporarily lift your mood, it often increases depression and anxiety over time.

Is Any Alcohol Safe with Antidepressants?

Effects vary by antidepressant type. Some healthcare providers say limited drinking—such as one serving per day—may be acceptable for those on certain SSRIs with low abuse risk. However, people taking MAOIs should avoid alcohol entirely due to life-threatening risks.

Most experts agree that drinking any amount of alcohol while on antidepressants is unsafe. Skipping a dose to drink is also harmful—it can cause withdrawal symptoms like muscle aches, headaches, dizziness, and nausea. Antidepressants take days to leave your system, so missing a dose doesn't make drinking safer.

Depression and alcohol misuse are closely linked. One study found nearly 65% of people dependent on alcohol were also depressed. Alcohol misuse is also a major factor in suicide attempts.

The Bottom Line

Mixing alcohol with antidepressants increases the risk of severe side effects and can worsen depression. If you're struggling to limit alcohol use while on antidepressants, seek help from a medical professional. Quitemate can also support you in reducing alcohol consumption by providing knowledge and tools to improve your physical and mental health.