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Jul 07, 2021
5 min read

Prozac and alcohol: risks and side effects

Prozac is the brand name for the generic antidepressant fluoxetine, a selective serotonin reuptake inhibitor (SSRI). People shouldn’t take Prozac with alcohol because of an increased risk of side effects. Also, drinking alcohol is usually counterproductive to successful treatment of mental health conditions, and excessive or long-term alcohol use has been linked to severe depression and anxiety disorders.

felix gussonePatricia Weiser PharmD

Reviewed by Felix Gussone, MD

Written by Patricia Weiser, PharmD

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Whether you’ve recently started taking Prozac 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. Drinking alcohol might provide temporary stress relief for some people, but it can lead to serious harm if you’re taking antidepressant medications, such as Prozac (see Important Safety Information). Read on to learn more.

What are the side effects of drinking alcohol with Prozac?

Mixing Prozac with alcohol may cause some harmful interactions. Prozac can sometimes cause drowsiness and influence your ability to make decisions and react quickly—especially in the first few weeks of taking Prozac or after your dose is increased (Eli Lilly, 2020). Since alcohol causes similar effects and carries these same risks, it’s not safe to mix alcohol with Prozac. 

Drinking alcohol with Prozac can also throw off your balance and coordination (Sohel, 2020). Besides interfering with these motor skills, this harmful combination could lead to respiratory depression (slow, shallow breathing).

Alcohol can also cause some of the same common side effects of Prozac, such as (Iranpour, 2019):

  • Anxiety
  • Diarrhea
  • Indigestion
  • Nausea
  • Sweating
  • Sexual side effects, such as abnormal ejaculation or impotence (inability to achieve an erection or orgasm) 

What is Prozac?

Prozac is a brand-name antidepressant. The Food and Drug Administration (FDA) approved the drug in 1987 (Eli Lilly, 2020).

It’s classified as a selective serotonin reuptake inhibitor (SSRI). Serotonin is “the feel-good hormone,” and it influences positive moods and emotions. Depression is thought to be associated with low levels of serotonin. SSRIs work by blocking serotonin’s reuptake (absorption) into neurons (nerve cells) in the brain, making more serotonin available between neurons.

Here are some quick facts about Prozac:

Besides its FDA-approved uses, some providers prescribe Prozac off-label to treat other mental health conditions such as social anxiety disorder and post-traumatic stress disorder (PTSD) (Sohel, 2020). 

Prozac carries a Black Box warning from the FDA because of an increased risk for suicidal thoughts and behaviors in people who take this medication. This risk is higher in young adults, teenagers, and children, especially during the first few months of taking the drug or after a dose increase. Because of this warning, your doctor will carefully monitor you or your loved one for signs of worsening depression (Rush, 2021).

The risks of mixing Prozac with alcohol

Alcohol is a depressant and affects your mood, thoughts, actions, and feelings (Iranpour, 2019). 

While alcohol can provide some short-term stress relief, long-term alcohol consumption can increase your chances of severe depression and anxiety. Depression and alcohol use disorder (AUD) are often linked (Kuria, 2012). In some cases, the two conditions can have a causal, vicious-cycle effect. This means that if you have major depressive disorder (MDD), for example, you have a greater chance of developing AUD, and if you have AUD, you have a greater chance of developing MDD.

For people already diagnosed with depression, drinking alcohol may interfere with the success of your treatment—including medications and talk therapy—even if you don’t have alcohol use disorder (Ramsey, 2005). 

Long-term alcohol use can cause your brain cells to adapt in ways that physically change your serotonin receptors (Lovinger, 1997). These changes can lead to physical dependence on alcohol and an increased risk of anxiety when you stop drinking. So, regularly consuming alcohol can be counterproductive to successfully treating an anxiety disorder.

FAQs about Prozac and alcohol

Here are some common questions you might have about Prozac and alcohol.

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

No, because Prozac has a very long half-life, meaning it takes weeks for Prozac to get completely cleared from your system (Eli Lilly, 2020). So, even if you don’t drink alcohol during the same time of day as your Prozac dose, both substances would still be in your system at the same time.

Can I skip my Prozac for a day, weekend, or vacation if I want to drink alcohol?

It’s not recommended to skip doses of your antidepressant for at least three reasons. First, it won’t be as effective in treating your depression or anxiety if you skip doses. Second, even if you skip doses, the drug will still be in your system as it takes weeks to get out of your system. And third, suddenly stopping SSRIs can lead to antidepressant discontinuation syndrome (Gabriel, 2017).

Side effects can include flu-like symptoms, fatigue (low energy), trouble falling asleep, nightmares, dizziness, or feeling irritable and anxious. However, this is less common with Prozac due to its long-lasting effects on the body.

Will drinking one alcoholic beverage with Prozac put me in danger?

It’s not likely that drinking one alcoholic beverage with Prozac will be life-threatening. However, one serving of alcohol can lead to several more, and alcohol use is often associated with poor decision-making. According to the Centers for Disease Control and Prevention (CDC), one serving of alcohol is defined as one of the following examples (CDC, 2021):

  • 12 ounces of beer (5% alcohol)
  • 8 ounces of malt liquor (7% alcohol)
  • 5 ounces of wine (12% alcohol)
  • 1.5 ounces of liquor such as vodka or rum (40% alcohol) 

Excessive drinking is responsible for more than 95,000 deaths each year in the United States (CDC, 2021; Esser, 2020). In addition, research has shown an increased risk of suicide immediately after alcohol consumption and heavy drinking (Iranpour, 2019).

Talk to a healthcare professional

You should not assume that any amount of alcohol is safe with Prozac without consulting with your healthcare provider first. They can make a personalized recommendation based on your mental health condition, individual health goals, and medical history.

If you feel like you can’t keep yourself from drinking, talk with your healthcare provider. They can work with you to identify any underlying causes. They might suggest other treatment options and recommend support groups or other medical advice to help you.

References

  1. Centers for Disease Control and Prevention (CDC). (2021). Alcohol use and your health. Retrieved from  https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
  2. Eli Lilly– PROZAC (fluoxetine capsules) for oral use. (2020). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/018936s109lbl.pdf
  3. Esser, M. B., et al. (2020). Deaths and years of potential life lost from excessive alcohol use — United States, 2011–2015. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/mm6939a6.htm
  4. Farah, W. H., et al. (2016). Non-pharmacological treatment of depression: a systematic review and evidence map. Evidence-Based Medicine, 21(6), 214–221. doi: 10.1136/ebmed-2016-110522. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27836921/
  5. Gabriel, M., & Sharma, V. (2017). Antidepressant discontinuation syndrome. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne, 189(21), E747. doi: 10.1503/cmaj.160991. Retrieved from  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449237/
  6. Iranpour, A., & Nakhaee, N. (2019). A review of alcohol-related harms: A recent update. Addiction & Health, 11(2), 129–137. doi: 10.22122/ahj.v11i2.225. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6633071/
  7. Kuria, M. W., Ndetei, D. M., Obot, I. S., Khasakhala, L. I., Bagaka, B. M., Mbugua, M. N., & Kamau, J. (2012). The association between alcohol dependence and depression before and after treatment for alcohol dependence. ISRN Psychiatry, 482802. doi: 10.5402/2012/482802. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658562/
  8. Lovinger D. M. (1997). Serotonin’s role in alcohol’s effects on the brain. Alcohol Health and Research World, 21(2), 114–120. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826824/
  9. Ramsey, S. E., Engler, P. A., & Stein, M. D. (2005). Alcohol use among depressed patients: The need for assessment and intervention. Professional Psychology, Research and Practice, 36(2), 203–207. doi: 10.1037/0735-7028.36.2.203. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874911/
  10. Simon, L. V., Keenaghan, M. (2021). Serotonin syndrome. [Updated 2021 Jan 23]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482377/
  11. Sohel, A. J., Shutter, M. C., & Molla, M. (2020). Fluoxetine. [Updated 2020 Jun 27]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459223/
  12. Rush, A John (2021). Effect of antidepressants on suicide risk in adults. In: UpToDate. Retrieved from https://www.uptodate.com/contents/effect-of-antidepressants-on-suicide-risk-in-adults