Lexapro and Alcohol: Risks, Effects, and Safety Tips

Written by Maureen Salamon
Medically Reviewed by Zilpah Sheikh, MD on February 19, 2025
5 min read

Escitalopram (Lexapro) is a drug that's often prescribed for depression or anxiety. It's a selective serotonin reuptake inhibitor (SSRI ), meaning it works by boosting the activity of the mood-regulating hormone serotonin in your brain.

If you take escitalopram, you may wonder if it's OK to have a cocktail, beer, or glass of wine once in a while. But doctors recommend that you stay away from alcohol when you take Lexapro or any other antidepressant.

That's because alcohol may not only stop escitalopram from working as it should but also increase side effects such as drowsiness. Sometimes, it could even be dangerous.

Even without alcohol in the mix, some common side effects of escitalopram include:

  • Nausea
  • Excessive sweating
  • Dry mouth
  • Trouble sleeping
  • Tiredness
  • Headache

Less commonly, you might have sexual problems, such as reduced sex drive.

In some cases, it could worsen your depression or lead to thoughts of suicide. Contact your doctor right away if this happens.

In rare cases, medications such as SSRIs (which cause high levels of serotonin to build up in your body) could cause a serious reaction called serotonin syndrome. It generally happens only when you start taking a different drug or increase the dosage of a drug you've been taking. It can cause:

  • Headache
  • Diarrhea
  • Restlessness
  • Confusion
  • Sleeplessness
  • Dilated pupils
  • A fast heart rate
  • High blood pressure
  • Stiff, twitching, or uncoordinated muscles

Seek medical help right away if you have these symptoms after starting a new drug or increasing your dosage. In more serious cases, you could have a high fever, shaking, seizures, or lose consciousness. Serotonin syndrome can be life-threatening. 

In clinical trials for Lexapro, the drug didn't increase alcohol's effects on thinking or motor skills. But the FDA still recommends that people not mix the two.

Drinking alcohol while taking escitalopram or another antidepressant can increase the drug's side effects and make you feel: 

  • Drowsy
  • Less alert
  • Less coordinated

While you may not feel drunker than you would otherwise, you might have trouble driving or doing other things that require you to be sharp. Your judgment may be affected, so you could make unwise or dangerous decisions. In extreme cases, it could even lead to violent behavior.

You may think of alcohol as something to lift your mood. But alcohol can make depression worse in the long run. Depression also raises your odds of alcohol abuse, so drinking can be especially risky for people who have it.

Drinking alcohol could also make it harder to treat your depression or anxiety. That's because alcohol can change the balance of chemicals in your brain that affect mood.

Because alcohol can cause depression and keep your antidepressant from working well, this could lead you to think about suicide. 

If your depression gets worse or you have thoughts of harming yourself, talk to your doctor immediately. They might tell you to stop taking Lexapro.

You may not want to skip having a drink just because you take an antidepressant. But if you want to raise a glass once in a while, you need to do it safely. 

Some doctors think it's OK to drink moderately if you take an SSRI such as Lexapro. "Moderate drinking" means no more than two drinks a day for men and one drink a day for women. One drink equals 12 ounces of beer, 5 ounces of wine, or 1 ounce of hard liquor.

But before you drink alcohol, you should take escitalopram long enough to know how it affects you and which side effects you have with it. Try to drink slowly, and have food along with your drinks, to tamp down alcohol's effects.

If you're at low risk of alcohol misuse and want to have a drink once in a while, it might be OK. Always talk to your doctor before drinking alcohol while taking an antidepressant.

Never temporarily stop taking an antidepressant so you can drink alcohol. You need to take these drugs consistently for them to be effective. Stopping and starting could make your anxiety or depression symptoms worse.

If you take the antidepressant escitalopram (Lexapro), it's best to avoid alcohol. Drinking alcohol can keep antidepressants from working effectively and increase your risk for many side effects. Talk to your doctor about your symptoms and side effects to check if drinking alcohol is safe for you.

What happens if you drink alcohol while taking Lexapro?

Drinking while you take an SSRI, such as Lexapro, can heighten side effects such as drowsiness and dizziness. It can affect your judgment, making it difficult to drive and do other tasks that require focus. Alcohol can also keep your antidepressant from working effectively.

Can Lexapro and alcohol cause blackouts?

It's possible. Lab studies haven't found major interactions between antidepressants and alcohol. But researchers have reported cases in which people who combined the two had "pathological intoxication" that included memory loss.

Can you die from Lexapro and alcohol?

Mixing alcohol and an antidepressant like Lexapro isn't thought to be fatal on its own. But drinking alcohol while you take a medication that may cause drowsiness could impair your judgment and raise your risk of accidents, such as car wrecks and falls.

Also, alcohol can keep antidepressants from working as well as they should. If not treated properly, depression can raise your chances of suicide.

What are Lexapro's side effects on women?

The most common side effects of escitalopram, such as nausea, headaches, and drowsiness, can affect anyone. Anyone could also have sexual side effects such as loss of libido. Women might have vaginal bleeding, or notice that they can't reach orgasm as they could before starting the drug.

You may be able to take Lexapro during pregnancy if your doctor approves. But it's not safe to take while breastfeeding.