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Can You Drink Alcohol While Taking Anxiety Medication?: A Clinical, Honest, and Essential Guide
- Dr Titilayo Akinsola
- 1 hour ago
- 4 min read
For many adults, having a glass of wine at dinner, celebrating with champagne, or enjoying a drink with friends is a normal part of social life. But when you begin anxiety medication—whether it’s an SSRI, SNRI, benzodiazepine, beta blocker, or antihistamine-based anxiolytic—one question becomes critically important:
“Can I drink alcohol while taking my anxiety medication?”
At Favor Mental Health, this is one of the most common (and misunderstood) concerns patients express. The short answer is:It depends on the medication, your body, and your mental health symptoms—but in many cases, alcohol can interfere with safety, effectiveness, and recovery.
This article breaks down, in advanced yet clear terms, why alcohol and anxiety medication rarely mix well, what happens inside your brain and body when they do, and how to make safe, informed decisions.
Why Alcohol and Anxiety Don’t Get Along
Before discussing medication, it’s important to understand how alcohol interacts with anxiety itself.
Many people mistakenly believe alcohol “calms them down.” In reality, alcohol is a central nervous system depressant that temporarily slows brain activity. This creates a short window where anxiety may feel reduced.
But here’s the hidden problem:Once alcohol leaves your system, your brain rebounds with heightened adrenaline, cortisol, and nervous system arousal.
This can lead to:
Rebound anxiety
Heart palpitations
Irritability
Trouble sleeping
Next-day panic
Dehydration (worsening physical anxiety symptoms)
Emotional instability
So even without medication, alcohol can amplify anxiety rather than soothe it.
How Alcohol Interacts With Anxiety Medications
Medications for anxiety target neurotransmitters responsible for mood regulation, fear response, and nervous system functioning.Alcohol disrupts these same systems.
This creates drug–alcohol interactions that range from mild to dangerous.
Below is a comprehensive breakdown by medication class.
1. SSRIs and Alcohol: A Risky Combination
(Sertraline, Fluoxetine, Escitalopram, Paroxetine, Citalopram)
SSRIs are the most frequently prescribed anxiety medications. While alcohol does not typically cause deadly reactions with SSRIs, the interaction can still be significant.
Why mixing alcohol with SSRIs is problematic:
Alcohol increases sedation → worsens fatigue
SSRIs + alcohol impair judgment more than alcohol alone
Alcohol weakens the effectiveness of SSRIs
Increased risk of depression relapse
Greater emotional volatility
Intensified next-day anxiety
Heightened risk of blackouts in sensitive individuals
SSRIs work by gradually stabilizing serotonin. Alcohol disrupts serotonin transmission—essentially undoing the progress the SSRI is making.
Bottom line:
Occasional low-volume drinking may be tolerated for some patients, but regular alcohol use undermines the effectiveness of SSRIs.
2. SNRIs and Alcohol: Increased Risk of Blood Pressure Changes
(Venlafaxine, Duloxetine)
SNRIs affect both serotonin and norepinephrine. Mixing alcohol with these medications can cause stronger physiological responses.
Risks include:
Spikes or drops in blood pressure
Worsening rapid heartbeat
Heart palpitations
Heightened sedation
Increased anxiety after drinking
Higher liver strain (especially with duloxetine)
Bottom line:
Alcohol interacts more strongly with SNRIs than with SSRIs. Avoidance is strongly recommended.
3. Benzodiazepines and Alcohol: A Dangerous, Potentially Life-Threatening Mix
(Lorazepam, Alprazolam, Clonazepam, Diazepam)
This is the most dangerous combination.
Both benzodiazepines and alcohol depress the central nervous system. When taken together, their effects multiply—not just add.
What can happen:
Extreme sedation
Slowed or stopped breathing
Loss of consciousness
Memory gaps
Impaired coordination
Dangerous drops in blood pressure
Respiratory depression
Overdose
Increased risk of accidents, falls, or blackouts
Even small amounts of alcohol can produce unpredictably intense reactions when combined with benzodiazepines.
Bottom line:
Never drink alcohol while taking benzodiazepines. The risks are too high.
4. Beta Blockers and Alcohol: Moderation Required
(Propranolol, Atenolol)
Beta blockers manage the physical symptoms of anxiety (racing heart, trembling). Alcohol also affects heart rate and blood pressure.
Mixing the two can cause:
Excessive blood pressure drops
Lightheadedness
Dizziness
Fainting risk
Unpredictable heart rate changes
Stronger intoxication sensations
Bottom line:
Generally discouraged, especially in large quantities.
5. Hydroxyzine and Alcohol: Extreme Sedation Risk
Hydroxyzine (Vistaril) is often used for acute anxiety or sleep issues.Both alcohol and hydroxyzine slow the brain.
Possible effects when combined:
Severe drowsiness
Impaired coordination
Confusion
Lowered breathing rate
Worsened panic after the sedation phase wears off
Bottom line:
This combination is unsafe and should be avoided.
6. Buspirone (Buspar) and Alcohol: Intensified Side Effects
Buspirone is a non-sedating long-term anxiety medication, but alcohol creates unpredictable interactions.
Risks include:
Increased dizziness
Nausea
Head pressure
Mood instability
Dramatic next-day anxiety
Bottom line:
Avoid mixing alcohol and buspirone whenever possible.
Why Alcohol Makes Anxiety Medication Less Effective
Most anxiety medications work by recalibrating the neurotransmitters that regulate:
Emotion
Fear
Stress response
Sleep cycles
Physical activation
Alcohol disrupts the same systems in the opposite direction.
This results in:
Slower healing
Reduced medication effectiveness
Longer treatment time
Higher risk of relapse
Increased emotional instability
The brain cannot fully recalibrate if alcohol keeps destabilizing the system.
How Long After Taking Anxiety Medication Can You Safely Drink?
This depends on the medication:
Benzodiazepines: absolutely no alcohol—period.
Hydroxyzine: avoid alcohol for at least 24 hours.
SSRIs/SNRIs/Buspirone: occasional small amounts may be tolerated, but only after stable use and approval from a provider.
Beta Blockers: caution, and only small amounts if approved.
It’s always best to consult your provider—your health, dosage, metabolism, and other medications matter.
Safer Alternatives to Drinking While on Anxiety Medication
If your goal is to relax socially without alcohol, consider:
Mocktails
Sparkling water with citrus
Adaptogenic drinks (non-alcoholic only)
Herbal teas
Social activities not centered around drinking
Breathwork before social events
Grounding or sensory-focused relaxation
These support mental health without disrupting treatment.
Favor Mental Health: Helping You Navigate Medication Safely
With over 17 years of clinical experience in anxiety treatment, Favor Mental Health provides:
✔ Full mental health evaluations
✔ Medication management
✔ Therapy for anxiety and trauma
✔ Personalized treatment plans
✔ Lifestyle and sleep coaching
✔ Substance use support
Location: Suite 9B, 260 Gateway Drive, Bel Air, MD 21014
Phone: 410-403-3299
You deserve anxiety treatment that works—without guesswork, without stigma, and without risking your safety.
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