Lexapro and alcohol: risks and side effects

Whether you’ve recently started taking Lexapro or if you’ve been taking it for a while, you may want to know whether it’s safe to drink alcohol while you’re on this medication. There are lots of reasons to stay away from alcohol while on Lexapro or generic escitalopram. Keep reading to learn more.

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Alcohol may cause harmful effects with Lexapro because both substances affect your central nervous system and may cause some of the same side effects. For example, both alcohol and Lexapro can make you feel sleepy and less alert. Although, with Lexapro, these effects are usually temporary when you first start treatment or after your dose has been increased (FDA, 2009).

Some of the more common side effects of Lexapro include (FDA, 2009):

• Nausea

• Trouble sleeping

• Increased sweating

• Sexual side effects, such as delayed ejaculation or difficulty achieving an orgasm

The manufacturer of Lexapro states that the drug didn’t increase the mental or physical impairments caused by alcohol when it was tested in clinical studies (FDA, 2009). However, the manufacturer still states that the combination of Lexapro and alcohol is not recommended. This is mostly due to the potentially negative effects that regular alcohol use can have on the treatment of anxiety and deprssion, and the increased risk of side effects.  

Lexapro is a brand-name antidepressant medication. It was approved by the Food and Drug Administration (FDA) in 2002 (Forest Laboratories, 2009). Lexapro’s generic name is escitalopram, and it belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Serotonin, known as “the feel-good hormone,” helps to regulate your positive moods and emotions. Depression is thought to be associated with low levels of serotonin in the brain. SSRIs work by blocking the reuptake (absorption) of serotonin, raising its levels. With more serotonin available, brain cells can better communicate with each other, which is thought to improve mood.

Here are some quick facts about Lexapro:

• Drug class: selective serotonin reuptake inhibitor (SSRI)

• Generic name: escitalopram

• Form: tablet and oral liquid solution

• Strengths: 5 milligrams (mg), 10 mg, 20 mg, and 1 mg/mL

• Usual dosing frequency: once a day

• FDA-approved uses:

  • Generalized anxiety disorder (GAD) in adults

  • Major depressive disorder (MDD) in adults and adolescents (ages 12 years and older)

Besides its FDA-approved uses, Lexapro is sometimes prescribed to treat other mental health conditions. Examples include social anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and certain menopause symptoms (Landy, 2021).

Lexapro carries a Black Box warning from the FDA because it may increase the risk of suicidal thoughts and behaviors. This risk is higher in young adults and adolescents who take this medication, especially after the drug is first started or after the dose is increased. Because of this risk, your doctor will carefully monitor you for signs of severe depression (Rush, 2021).

Alcohol acts as a depressant on your central nervous system. It affects your mood, thoughts, actions, and feelings and could cause symptoms of depression (Iranpour, 2019). Consuming alcohol may provide temporary feelings of relaxation for some people, but long-term use increases your risk of severe anxiety and depression. 

Long-term alcohol use can cause changes in your brain, including physical changes in your serotonin receptors (Lovinger, 1997). These changes may lead to alcohol dependence, alcohol use disorder (AUD), or increased anxiety levels when you stop drinking. So, regularly drinking alcohol can work against you in the long run when you’re trying to treat an anxiety disorder.

If you’ve been diagnosed with depression, drinking alcohol may interfere with the success of your overall treatment plan and make your depression worse (Ramsey, 2005). The use of alcohol can also cause liver problems, make depression symptoms worse, and can negatively impact your brain functioning (Iranpour, 2019).

Here are some common questions you may have about mixing Lexapro with alcohol.

Would drinking one alcoholic beverage with Lexapro really put me in danger?

If you take Lexapro, it’s not likely that one serving of alcohol will be life-threatening. According to the Centers for Disease Control and Prevention (CDC), a single serving of alcohol is one of the following examples (CDC, 2021):

• 12 ounces of beer (5% alcohol)

• 5 ounces of wine (12% alcohol)

• 1.5 ounces of liquor such as whiskey or vodka (40% alcohol)  

However, sometimes, consuming one serving of alcohol can lead to another. This is because even one alcoholic beverage can lead to poor decision-making. It’s best not to assume that any amount of alcohol is safe with Lexapro without consulting your healthcare provider first. They can make a recommendation customized to your medical history and treatment goals.

If I take Lexapro in the morning, is it safe to drink alcohol in the evening?

No, because Lexapro’s effects last for at least 24 hours, although it reaches its highest levels in your blood about 5 hours after you take it (FDA, 2009). So, even if you would take Lexapro in the morning but drink alcohol later that evening, both substances would be in your system at the same time.

If I want to drink alcohol, is it okay to skip my Lexapro for a day, weekend, or while on vacation?

It’s not recommended to skip doses of your antidepressant. You shouldn’t temporarily or suddenly stop taking Lexapro or any medication without first talking to your healthcare provider. Abruptly stopping Lexapro can cause side effects that could put a damper on your weekend or vacation. Possible side effects of suddenly stopping Lexapro include mood changes, irritability, nausea, dizziness, electric shock-like sensations, headache, confusion, and low energy levels (Forest Laboratories, 2009; Landy, 2021). Also, skipping doses of this medication makes it less effective.  

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

July 08, 2021

Written by

Patricia Weiser, PharmD

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.