Prozac and alcohol: risks and side effects

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. Read on to learn more.

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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) 

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:

• Drug class: selective serotonin reuptake inhibitor (SSRI)

• Generic name: fluoxetine

• Form: capsule

• Strengths: 10 milligrams (mg), 20 mg, and 40 mg

• Usual dosing frequency: once a day

• FDA-approved uses:

  • Major depressive disorder (MDD)

  • Obsessive-compulsive disorder (OCD)

  • Bulimia nervosa

  • Panic disorder, with or without agoraphobia (fear of leaving home or entering open or crowded places)

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).

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.

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).

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.

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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.

Current version

July 07, 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.