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Ask the Psychiatric Pharmacist #20

Effects of Wine Intake on Antidepressant Medications

On the vial for my antidepressant, a warning label states that I should not drink alcoholic beverages with this medication.  I like to have a glass of wine with dinner though, and my doctor told me that this will lower my risk of heart disease.  Can I just have one glass of wine with dinner?

Drinking alcohol while taking antidepressants is generally not recommended because both of these substances can make you drowsy, less alert, and uncoordinated.  When taken together, those effects are increased.  However, since many patients are not willing to give up alcohol completely, it is important to combine alcohol and antidepressants in the safest way possible.

Some physicians allow moderate drinking for their patients.  This means 1 drink per day for women and 2 drinks per day for men.  “One Drink” is equivalent to 12 ounces of beer, 5 ounces of wine, 1 ounce of 80-proof whiskey, or 1 ounce of 100-proof spirits.  It is also a good idea to drink slowly and eat some food while drinking to decrease the effects of the alcohol.  However, you should not combine alcohol with your antidepressant until you know how your antidepressant will affect you.  Many antidepressants will make people feel drowsy, dizzy, and less alert.  People who experience these effects from their antidepressant will likely not be able to tolerate the combined effects of alcohol and antidepressants, and will not be able to perform routine tasks such as driving or operating machinery.

Combining alcohol with antidepressants could potentially be fatal.  Alcohol can cause depression itself and also keeps some antidepressants from working as well as they should.  This could lead to an increase in suicidal thoughts and actions.  Also, if you drink alcohol while taking a certain type of antidepressant called an MAOI, your blood pressure could rise dramatically and could even cause a stroke.  Finally, sometimes the liver cannot process all of the toxins present when alcohol is combined with antidepressants and fatal toxicity can occur.

The bottom line is that there are many reasons not to combine alcohol with antidepressants.  If you wish to drink alcohol while taking an antidepressant, do so moderately and safely.

Written By:  Katie Pearsall, PharmD Candidate and Steven M. Burghart DPh, MBA, BCPP