Is it okay to drink alcohol while on Zoloft?

Dear Alice,

I just started taking Zoloft today. I am going on vacation next week and am wondering if it is safe to drink while on this medication. I can't seem to get a straight answer from anyone. I'm not talking about drinking to oblivion; I'm talking about having a couple of drinks by the campfire. Is this okay?

Dear Reader,

It's great that you're thinking about the way your medications may interact with other substances! Many people who take Zoloft, known generically as sertraline, or other depression-related medications drink light to moderate amounts of alcohol without serious side effects, or any effects at all. However, the U.S. Food & Drug Administration (FDA) recommends against drinking while using sertraline to avoid side effects or the worsening of depressive symptoms. Every person may react differently when using alcohol with sertraline, and research on the interactions between the two are unfortunately lacking. If you choose to drink moderately on your medication, it's good to understand what the possible interactions may be.

Sertraline is an antidepressant in the class known as selective serotonin reuptake inhibitors, or SSRIs. It affects your brain's ability to absorb serotonin, which acts as a neurotransmitter, transmitting nerve impulses between nerve cells and affecting mood. Alcohol, on the other hand, is a central nervous system depressant, meaning that it slows activity in the brain and nervous system, causing symptoms such as drowsiness, poor coordination, or slurred speech.

When there's a noticeable reaction from mixing alcohol with antidepressants, it's often an amplified response to the alcohol (i.e., one drink may end up feeling like two.) If you usually feel tired, or even a bit depressed, after drinking, then you might feel even more so if you're on antidepressants. Similarly, the shaky motor skills and slower reaction time that commonly accompany a night of drinking may get even worse when antidepressants are present — and these responses can occur suddenly and unexpectedly. You may also experience dizziness or difficulty concentrating. Sertraline, and the other antidepressants like it, can produce sedative effects, which may lead to lowered heart rate and blood pressure changes that might worsen while drinking. This becomes even more likely as the quantity of alcohol consumed increases. Other symptoms, including headaches and sexual dysfunction, are also sometimes associated with both medications used to treat depression when taken while also consuming alcohol.

Alcohol also alters your brain's production of serotonin, which is why using these two drugs together could decrease sertraline's ability to reduce symptoms of depression. It's even possible that you could feel more anxious or depressed from mixing sertraline with alcohol. Side effects may become more severe (and even less predictable) if you're taking more than one medication. It may be helpful to discuss all of your medications with your healthcare provider when deciding whether or not to drink alcohol. 

Often, the side effects associated with sertraline, and other similar medications, subside after the first few weeks of use. When starting any new drug, as you just have, it's a good idea to see how your new medication will affect you free from other drugs, such as alcohol. This way you won't be wondering which drug might be causing a reaction. Also, after using sertraline for a while, your reactions when mixing it with alcohol may change. Staying attuned to your physical and emotional reactions can help you determine what's going on and why.

Whether or not you choose to drink, it's recommended to take your medication consistently and as prescribed by your health care provider. Stopping your medication in order to drink alcohol isn't recommended, as most antidepressants won't work properly if you don't have the correct dose in your system. Inconsistent use may also cause side effects, including worsened symptoms of depression. 

As you've demonstrated, understanding the way different drugs affect one another, and affect you, is very helpful. This is true not only of illicit substances, but also of legal drugs, such as alcohol, nicotine, and prescription and over-the-counter medications. Indeed, some drug combinations are complicated or could pose a health risk, and your health care provider is the best source of information regarding the possible effects of the drugs they're prescribing to you. You may also reach out to a pharmacist, whose expertise is in knowing about various types of drugs and their reactions with other substances. 

Happy camping,

Last updated Jul 22, 2022
Originally published Apr 09, 1999

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