Anxiety Medication and Alcohol

Risks of Mixing Anxiety Medication and Alcohol & Best Treatment Options
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Mixing Anxiety Medication and Alcohol

Many anxiety meds have central nervous system (brain and spinal cord) depressant activity and interact with alcohol, so it is crucial to understand your risks. A wide variety of prescription drugs from different classes, such as antidepressants or benzodiazepines, are used for various anxiety treatments. Side effects like drowsiness, impaired driving, and respiratory depression (slowed breathing) can worsen when anxiety meds and alcohol are mixed. It is important to note that there are non-addictive anti-anxiety medications, and you just have to consult your doctor about them. Combining anxiety medication and alcohol generate anxiety, panic, and phobias [1].

Alcohol and anxiety can become a dangerous, self-perpetuating cycle. According to the National Center for Biotechnology Information (NCBI) [2], the co-occurrence of alcohol and anxiety disorders is relatively common. The research found that 20% of those with social anxiety have an alcohol misuse problem.

Alcohol can lower the levels of serotonin, or what’s generally known as the happiness hormone. As a result, reduced levels are associated with increased anxiety. Moreover, the body will ultimately build up a tolerance to alcohol, making it less efficient for producing relaxing and calming effects. Additionally, ongoing alcohol use can result in a different set of health issues and complications.

Anxiety sometimes called nervousness, is a common emotional disorder with differing levels of intensity. A person with anxiety typically has chronic, ongoing bouts of worry, fear, or concern, typically out of proportion to the actual troubles they may face in their everyday lives. Physical symptoms of anxiety can include sweating, trembling, elevated blood pressure, and rapid breathing. The symptoms can go on for an extended period of time, usually months, without relief. In this case, the person may have Generalized Anxiety Disorder (GAD). Anxiety medication and alcohol are both considered psychoactive drugs.

Anxiety medication and alcohol
Anxiety disorder makes an individual start drinking alcohol, which worsens their anxiety, which leads them to drink more and worsens their anxiety further. It’s a never-ending vicious cycle of alcohol and anxiety.

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Risks of Mixing Anxiety Meds and Alcohol 

It’s best to avoid mixing combining antidepressants or anxiety meds and alcohol. It may worsen your symptoms, and it can be dangerous and life-threatening.

If you mix anxiety meds and alcohol:

You may feel more depressed or anxious. Drinking can counteract the benefits of your anxiety meds, making your symptoms more difficult to treat. Alcohol may seem to improve your mood in the short term, but its overall effect increases symptoms of depression and anxiety.

Side effects may be worse if you also take another medication. Many medications can cause problems when taken with alcohol — including anti-anxiety medications, sleep medications, and prescription pain medications. Side effects may worsen if you drink alcohol and take one of these drugs along with an antidepressant.

You may be at risk of a dangerous reaction if you take MAOIs. When combined with certain alcoholic beverages and foods, anxiety meds called monoamine oxidase inhibitors (MAOIs) can cause a dangerous spike in blood pressure. If you take an MAOI, be sure you know what’s safe to eat and drink, and which alcoholic beverages are likely to cause a reaction.

Your thinking and alertness may be impaired. The combination of antidepressants and alcohol will affect your judgment, coordination, motor skills, and reaction time more than alcohol alone. Some combinations may make you sleepy. This can impair your ability to drive or do other tasks that require focus and attention.

You may become sedated or feel drowsy. A few antidepressants cause sedation and drowsiness, and so does alcohol. However, when taken together, the combined effect can be intensified.

Don’t stop taking an antidepressant or anxiety meds just so that you can drink. Most anxiety meds require taking a consistent, daily dose to maintain a constant level in your system and work as intended. Stopping and starting your medications can make your depression worse. While it’s generally best not to drink at all if you’re depressed, ask your doctor. If you have depression:

You may be at risk of alcohol abuse. People with depression are at increased risk of substance abuse and addiction. If you have trouble controlling your alcohol use, you may need treatment for alcohol dependence before your depression improves.

You may have trouble sleeping. Some people who are depressed have difficulty sleeping. Using alcohol to help you sleep may let you fall asleep quickly, but you tend to wake up more in the middle of the night.

AtivanAnxiety Medication and Alcohol

Ativan (lorazepam) is a prescription drug that is often used to treat anxiety, insomnia, continuous seizures, and as a medication used right before anesthesia. Ativan’s active ingredient is benzodiazepine. Benzodiazepines have sedative properties that are most commonly used for anxiety relief, as a muscle relaxant, and as amnesia. Ativan is a Schedule IV controlled substance, and its use can lead to abuse and dependence.

Because Ativan is extremely potent and can appear harmless as a prescription drug, it may cause both accidental and intentional abuse as well as an accidental overdose. Most commonly, overdoses happen when it is taken in combination with alcohol or other drugs.

According to the US Food and Drugs Administration (FDA) [3], the use of benzodiazepines, including lorazepam or Ativan, may lead to physical and psychological dependence. The risk of Ativan addiction increases with higher doses and longer-term use and is further increased in persons with a history of alcoholism or drug abuse or in persons with significant mood and personality disorders.

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Xanax – Anxiety Medication and Alcohol

Xanax is a brand of alprazolam, is a benzodiazepine. It is thought that alprazolam works by enhancing the activity of certain neurotransmitters in the brain. Xanax is prescribed to treat anxiety and anxiety caused by depression. It is also used to treat panic disorders with or without a fear of places and situations that might cause panic, helplessness, or embarrassment (agoraphobia).

Anxiety medication and alcohol
Drinking can counteract the benefits of your antidepressant medication, making your symptoms more difficult to treat.

Avoid drinking alcohol if you are taking Xanax bars. Dangerous side effects or death could happen. Xanax can cause more serious side effects in severe cases, such as fainting, hallucinations, jaundice, convulsions, and seizures. In addition, Alprazolam does not safely interact with Alcohol, other Opioids, Benzodiazepines, anticonvulsants, or antihistamines.

An overdose on Xanax can be life-threatening, especially if the substance is taken with alcohol. Alcohol is particularly dangerous when mixed with Xanax bars because they are both depressants; combining the two can lead to an overdose and respiratory failure.

Overdose deaths involving benzodiazepines (including Xanax) increased from 0.58 per 100,000 adults in 1996 to 3.07 in 2010. Moreover, data shows that 11,537 overdose deaths involving benzodiazepines occurred in 2017 [4]. 

Zoloft – Anxiety Medication and Alcohol

Zoloft is the brand name of the prescription drug Sertraline. It is an antidepressant that belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). This prescription drug is used to treat the major depressive disorderpanic disorderobsessive-compulsive disorder, premenstrual dysphoric disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder[

It’s not safe to combine Zoloft with alcohol. Zoloft and alcohol are both drugs that interact with your brain, and medical professionals recommend not to take Zoloft and alcohol simultaneously. This is because alcohol can increase the nervous system side effects of Zoloft, including drowsiness, dizziness, and difficulty concentrating. For this reason, it is recommended to avoid drinking alcohol while you are taking Zoloft, especially if you are planning to operate machinery or drive.

Drinking alcohol causes the Zoloft side effects to happen more intensely and quickly. Zoloft and alcohol can both cause sedation, and drinking can intensify the sedative effects of Zoloft. This can make you feel drowsiness much faster than if you were drinking alcohol alone. Some individuals also experience an upset stomach when using this drug. Combining Zoloft and alcohol can worsen the symptoms of an upset stomach that may result in vomiting.

Alcohol is a central nervous system (CNS) depressant that by itself can cause depression. The misuse of alcohol can also worsen the symptoms of depression and make Zoloft less effective in treating these symptoms. This can increase suicidal thoughts and actions in individuals who drink alcohol when taking Zoloft. If you have depression, your doctor will likely tell you not to drink alcohol, regardless of whether or not you are taking Zoloft.

How does Alcohol Affect People with Anxiety?

Alcohol works as a sedative, so it can help someone feel more at ease. Also, it may make the individual feel more socially confident at a party or help forget worries. However, these are short-term benefits. When someone drinks alcohol, it disturbs the balance of chemicals and processes in the brain. The relaxed feeling an individual may experience during the first drink is because of the chemical changes alcohol causes in the brain.

Is alcohol a depressant? Yes, alcohol works by depressing the part of the brain that we associate with inhibition. But these effects wear off fast, and the pleasant feelings fade. If people rely on a substance like alcohol to mask anxiety problems, they may become dependent on it to relax, leading to alcoholism.

A possible side-effect of this is that the more a person drinks, the greater the tolerance for alcohol. Over a period of time, the person may need to drink more alcohol to get the same feeling. Thus, this pattern of alcohol abuse may affect mental health in the long term.

In conditions like extreme anxiety that need to be treated by a medical professional, doctors will generally prescribe benzodiazepines or benzo’s, as they are CNS depressants. However, the effects that make benzodiazepines helpful in these diagnoses are the same effects many experiences with alcohol.

In situations where an individual cannot acquire a prescription for their anxiety disorder, possibly the doctor does not think it warrants a prescription or wants the person to try other methods to get their anxiety under control, the person suffering may resort to alcohol.

This is also very common among people struggling with an anxiety disorder who either cannot afford therapy or are too embarrassed to seek it. While this may seem like it works initially, in truth, the little help that alcohol gives is only temporary, and it comes with a great cost.

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SSRIsAnxiety Medication and Alcohol

SSRIs (Selective Serotonin Reuptake Inhibitors) are a class of medication that is one of the most commonly prescribed in anxiety disorder treatment. This medication increases the amount of serotonin in the brain. It aims to improve mental health by binding to neurotransmitter receptors in the brain, which ultimately leads to the reduction of stress and improved mood.

Anxiety meds like Prozac, Celexa, Paxil, and Zoloft are known as selective serotonin uptake inhibitors (SSRIs). It is commonly prescribed to people suffering from anxiety. These drugs work differently than anxiolytics by making the brain’s supply of serotonin more available, therefore boosting one’s mood.

Because they function differently in the brain, they also interact with alcohol in a different way. While medical professionals don’t entirely understand the mechanisms, it has been shown that mixing alcohol and SSRIs can lower your alcohol tolerance and cause memory loss. While it may be true that the combination can feel good in the short term, it can reduce the effectiveness of the medication and increase anxiety levels over time.

Regular mixing of alcohol and SSRIs can also cause individuals to develop side effects of the drug, such as weight gain, insomnia, and nausea. It is important to note that mixing these anti-depressive drugs with alcohol can be life-threatening resulting in a dangerous spike in blood pressure which can lead to cardiovascular problems.

Are there any Anxiety Medications that aren’t Affected by Alcohol? 

Anxiety medications can treat anxiety disorders effectively, but they can become dangerous when combined with alcohol abuse. Alcohol and benzodiazepines shouldn’t mix because together they can impact the body and delay recovery. Alcohol and SSRIs are volatile combinations that can also have adverse effects.

Benzodiazepines, such as Ativan, Xanax, Valium, Klonopin, and Librium, are anxiolytic medications used to reduce anxiety symptoms by having a sedative effect. They are the most commonly prescribed medications for anxiety disorders. They act on receptors for the inhibitory neurotransmitter GABA, making its transmission much more efficient. The increased efficiency of GABA results in the sedative effect, thus slowing and calming the central nervous system and effectively reducing the excitatory, panic-like symptoms of anxiety.

Alcohol acts similarly to GABA by imitating, binding to its receptors, and producing the familiar sedative effect. This is the reason that physicians commonly use anxiolytic medications to wean patients off of alcohol and reduce symptoms of withdrawal. It also may help us understand why some individuals who take anxiolytics also develop an alcohol addiction. 

Both anxiety medication and alcohol impact the same neurotransmitter and have similar physiological results. It is common for people to build up a tolerance to their anti-anxiety medication and then turn to alcohol as a form of self-medication, sometimes resulting in a co-occurring alcohol and benzodiazepine addiction.

Anxiety and Alcohol Consumption

“Hangxiety” has become a buzzword that defines the uneasy feeling that usually defines heavy alcohol use, but what does it mean? It is the feeling of being “on edge” after a night of drinking. It is also the feeling that “something’s not right” and being paranoid or flat out scared, and can’t explain why. This phenomenon is an example of an anxiety hangover, more commonly known as “hangxiety”.

Although even a heavy night of drinking may trigger anxiety, major alcohol withdrawal symptoms and bad hangovers make alcohol panic attacks even more likely. Hangovers can also add to stress if a person can’t function or has to miss school or work.

If it’s a severe hangover, a person can experience:

  • Sweating
  • Nausea
  • Paranoia
  • Psychosis
  • Trembling
  • Elevated heart rate

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If you or your loved one are using alcohol as a self-medicating measure, you might feel that it “works” to help you cope with your alcohol and anxiety disorders symptoms. However, while you might feel that it works in the short term, it’s more likely to cause you problems in the long run. If you have an anxiety disorder, alcohol misuse and withdrawal can worsen your symptoms.

If you or your loved one have anxiety and are using anxiety medication and alcohol to cope, you must seek support from your doctor or mental health professional. It’s never too late to reach out for help if you are trying to cope with co-occurring mental health conditions and substance use disorders.

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Anxiety medication and alcohol
Both long-term alcohol misuse and alcohol withdrawal can significantly increase anxiety levels

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[1] [2] NCBI –

[3] FDA –

[4] CDC –