Can You Drink While Taking Lexapro for Anxiety and Depression?

We finally decided to take control of our mental health! We’re seeing a psychiatrist, and they’ve prescribed Lexapro for our anxiety and depression. Not much changed at first, but after about a month, it kicked in! We’re starting to feel more relaxed, and we’re enjoying the things we loved again. We want to do something fun. Maybe we should go out with some friends? Can we drink on Lexapro — or skip a dose to drink?

In this article, we’ll learn that drinking alcohol while on Lexapro can make our symptoms of anxiety and depression worse. And we’ll learn the science behind Lexapro and alcohol — and what happens if we mix them. 

What Are Anxiety and Depression? 

Approximately 1 in 4 people have a mental health condition. Anxiety and depression are two of the most common: nearly 18% of people in the U.S. have a diagnosed anxiety disorder while 9.5% have been diagnosed with depression.  

Anxiety is something most of us have experienced because it is essentially our normal way of adapting to stress or danger. Anxiety becomes an issue when we have excessive, persistent, and uncontrollable worry. There is a range of anxiety disorders, but among those most commonly diagnosed are generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, and specific phobias. Although these disorders have their own criteria and symptoms, some shared symptoms of anxiety disorders are excessive worrying, restlessness, muscle tension, difficulty concentrating, irritability, sleep problems, increased heart rate, and sweating. 

We may all experience ups and downs, but depression goes beyond the normal lows. Depression is a mood disorder that is characterized by persistent feelings of sadness, hopelessness, and emptiness. The most common depressive disorders include major depressive disorder (MDD), persistent disorder, bipolar disorder, and seasonal affective disorder (SAD). Symptoms of depressive disorders include loss of interest in pleasurable activities, changes in appetite, changes in sleep patterns, fatigue, feeling worthless or guilty, difficulty concentrating, and thoughts of death or suicide. To be diagnosed with a depressive disorder, we must experience these symptoms for at least two weeks, and the condition has to be interfering with our daily functioning. 

In both anxiety and depression, our brain lacks an important neurotransmitter, serotonin. A neurotransmitter is a chemical that our brain uses for communication. Serotonin is the “mood regulator” chemical in our brain, so when serotonin is in low supply, we can become depressed or anxious. It is important to remember how complex our brain is and, although serotonin is a key component of depression and anxiety, other chemicals also contribute to these disorders, including dopamine, gamma-aminobutyric acid (GABA), and norepinephrine. 

Lexapro: A Treatment for Anxiety and Depression

Lexapro is the brand name medication for escitalopram, a selective serotonin reuptake inhibitor (SSRI). SSRIs are a class of medications known as antidepressants. Lexapro is primarily used to treat major depressive disorder (MDD) and generalized anxiety disorder (GAD) by increasing the amount of serotonin in the brain. As an SSRI, Lexapro inhibits the reuptake of serotonin, but what does that actually mean?

A neurotransmitter, serotonin is released into synapses, the tiny spaces between cells in our brain (neurons). Here, the serotonin will find nearby neurons to bind with, but not all of the serotonin that is released is used so there is extra in the synapse. The excess serotonin will get reabsorbed into the neuron it was released from through a process called reuptake. So, because SSRIs prevent reuptake, more serotonin is  left in the synapse to bind with other neurons. This is advantageous for those with anxiety and depressive disorders who have lower levels of serotonin. 

Although Lexapro can be successful in treating MDD and GAD, a host of side effects are associated with the medication. Let’s review some common side effects of escitalopram. 


• Nausea
• Headaches
• Dry mouth
• Sleepiness or unusual drowsiness 
• Trouble sleeping
• Feeling tired or weak
• Changes in appetite
• Increased sweating
• Decreased sex drive or performance


Most side effects will resolve within a few weeks of starting Lexapro. If they do not, talk to your medical provider. There are some rare but serious side effects associated with Lexapro, including seizures, dizziness, trouble breathing, fast or irregular heartbeat, and confusion. Seek immediate medical attention if you experience any of these symptoms.

Alcohol and Our Mental Health 

Alcohol is a depressant, meaning it slows down certain brain activity and makes us feel relaxed and euphoric —  at first. However, after the initial relaxing feelings, we can begin to feel more anxious and/or depressed. Alcohol can intensify our feelings of sadness, anxiety, and  irritability. Chronic alcohol use increases our risk of developing depression or anxiety disorders. 

Alcohol slows our brain primarily through mechanisms associated with  GABA, the primary inhibitory neurotransmitter in our brain. As we drink alcohol, levels of GABA increase. However, alcohol also affects other neurotransmitters such as dopamine and serotonin — both of which are increased after drinking alcohol. Long-term alcohol use alters our brain and the neurotransmitter system to compensate for the initial increases of GABA, dopamine, and serotonin. But, over time, GABA, dopamine, and serotonin levels and actions are decreased. These changes continue to worsen our depression and anxiety with chronic alcohol use. 

How Do Lexapro and Alcohol Interact? 

Alcohol and Lexapro both affect our serotonin system. As we’ve learned, Lexapro blocks the reuptake of serotonin. As we first consume alcohol, serotonin levels increase. As alcohol and Lexapro interact, the side effects of each may increase. The following are some symptoms we may experience if we drink alcohol while taking escitalopram: 


• Drowsiness
• Nausea
• Lack of energy 
• Heachaches 
• Loss of coordination 
• Memory issues


These symptoms are typical of alcohol use, but our chances of experiencing them — and more intensely — increase when we combine Lexapro and alcohol. So, should you drink on Lexapro? Let’s look into the risks.

Risks of Drinking Alcohol While on Lexapro

There are several risks associated with mixing Lexapro and alcohol. Let’s review them.

• Liver damage. Alcohol and Lexapro are processed in the liver and, when combined, can put extra strain on that organ, making it more vulnerable to damage. At high doses, alcohol can cause severe damage to the liver. 

• Serotonin syndrome. Serotonin syndrome occurs when there’s an excessive amount of serotonin being released at the same time. Serotonin syndrome can lead to restlessness, confusion, insomnia, dilated pupils, loss of muscle coordination, heavy sweating, diarrhea, shivering, fever, tremors, seizures, irregular heartbeat, or unconsciousness. Although rare, serotonin syndrome requires immediate medical attention. 

• Depression and anxiety symptoms. Alcohol can exacerbate our symptoms of depression and anxiety; chronic drinking can counteract Lexapro and block its benefits.

• Thoughts of suicide. Some people may experience suicidal thoughts when mixing alcohol and Lexapro. (Call 988 or seek immediate medical attention if you have thoughts of suicide.)  

• Alcohol dependence. Research shows that those treated with SSRIs experience increased cravings for alcohol and are at greater risk for developing alcohol dependence. 

Not everyone taking Lexapro will experience these risks. Those of us who are on a higher dose of Lexapro or who drink more alcohol are at greater risk of developing more severe symptoms when mixing the two. We know the associated risks and how Lexapro and alcohol interact, but let’s get down to whether you can drink while taking Lexapro for anxiety and depression. 


Can I Drink Alcohol If I Take Lexapro? 


Most doctors recommend avoiding alcohol while on Lexapro. However, based on the information here, we still might wonder, can I have an occasional drink while on Lexapro? 

Short answer, yes ... but — we should also consult with our prescribing medical professional before we consume alcohol. If our symptoms of depression and anxiety are well managed, having one or two drinks while taking Lexapro will likely not lead to immediate harm. The key is moderation — limiting our overall alcohol intake, drinking slowly, and and eating food beforehand. 

We should never skip a dose of Lexapro to drink alcohol! In fact, we should never go off Lexapro without consulting a physician. Going off Lexapro requires us to gradually reduce the amount we take so we don’t experience withdrawal symptoms. Lexapro withdrawal symptoms include increased anxiety, confusion, dizziness, headaches, irritability, nausea, trouble sleeping, unusual tiredness, burning or tingling, and brain zaps. 


Alternatives to Alcohol on Escitalopram


If, after checking with your doctor, you decide it’s best to avoid alcohol while on Lexapro, what are some alternatives to alcohol?

• Try a new mocktail recipe or a non-alcoholic beer! 
• Enjoy a mug of exotic tea while reading a new book or watching a favorite show.
• Plan a sober activity with friends, like a hike or a get-together at a favorite coffee shop. 
• Try Reframe to help cut back or quit alcohol!