What are the effects of combining Escitalopram (Citalopram's active enantiomer) and alcohol?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 27, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

It is strongly advised to avoid consuming alcohol while taking escitalopram due to the potential for increased side effects and reduced medication effectiveness. Combining escitalopram with alcohol can lead to enhanced sedative effects, including drowsiness, dizziness, and impaired coordination, which can make activities like driving hazardous 1. Alcohol consumption can also exacerbate depression and anxiety symptoms that escitalopram is intended to treat, thereby reducing the medication's efficacy. Furthermore, the interaction between alcohol and escitalopram may increase the risk of serotonin-related side effects, as both substances influence brain chemistry, particularly serotonin pathways.

Some key considerations when taking escitalopram include:

  • The potential for increased risk of rare but serious side effects like liver problems when combined with alcohol
  • The importance of monitoring for increased side effects if alcohol is accidentally consumed while on escitalopram
  • The need to seek medical attention immediately if severe symptoms like extreme drowsiness, confusion, or difficulty breathing occur
  • The value of consulting a healthcare provider for personalized advice on medication regimens, especially considering individual medical history and current health status

Given the potential risks and interactions, it is crucial to avoid alcohol consumption while taking escitalopram to ensure the safest and most effective treatment outcome. This recommendation is based on the most recent and highest quality evidence available, emphasizing the importance of cautious medication management and lifestyle choices to optimize treatment benefits and minimize risks 1.

From the FDA Drug Label

Although Escitalopram did not potentiate the cognitive and motor effects of alcohol in a clinical trial, as with other psychotropic medications, the use of alcohol by patients taking Escitalopram is not recommended. Do not drink alcohol while using Escitalopram tablets Patients should be told that, although Escitalopram has not been shown in experiments with normal subjects to increase the mental and motor skill impairments caused by alcohol, the concomitant use of Escitalopram and alcohol in depressed patients is not advised

The use of alcohol by patients taking Escitalopram is not recommended. While Escitalopram did not potentiate the cognitive and motor effects of alcohol in a clinical trial, caution is advised due to the potential risks associated with concomitant use. Patients should be instructed to avoid drinking alcohol while taking Escitalopram tablets 2, 2, 2.

From the Research

Escitalopram and Alcohol Interaction

  • The interaction between escitalopram and alcohol is a significant concern, as it may lead to adverse effects such as serotonin syndrome 3.
  • A case report published in 2019 described a patient who developed serotonin syndrome after consuming alcohol while being treated with escitalopram and clomipramine 3.
  • The exact mechanism of this interaction is not fully understood, but it is thought to be related to the pharmacodynamic and pharmacokinetic effects of alcohol on escitalopram and other antidepressants 3, 4.

Adverse Effects of Escitalopram and Alcohol

  • The combination of escitalopram and alcohol may increase the risk of adverse effects such as pathological intoxication, memory impairment, and violent behavior 4.
  • A review of multiple case reports found that 100 out of 201 reports showed evidence of pathological intoxication, with 53 cases involving memory impairment 4.
  • The risk of serious violence, including homicide, is also a concern when combining escitalopram and alcohol 4.

Mechanism of Action of Escitalopram

  • Escitalopram is a selective serotonin reuptake inhibitor (SSRI) that works by increasing extracellular serotonin levels in the brain 5, 6.
  • It has a unique mechanism of action, with an allosteric effect at the serotonin transporter, which may contribute to its efficacy and safety profile 6.
  • The exact mechanism of the interaction between escitalopram and alcohol is not fully understood, but it is thought to be related to the effects of alcohol on the serotonin transporter and other neurotransmitter systems 3, 4.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

4
Research

Interaction between antidepressants and alcohol: signal amplification by multiple case reports.

The International journal of risk & safety in medicine, 2014

5
Research

Escitalopram.

Drugs of today (Barcelona, Spain : 1998), 2004

Related Questions

Why does the combination of citalopram (SSRI), sertraline (SSRI), chlorpheniramine (antihistamine) and orphenadrine (muscle relaxant) exacerbate symptoms similar to alcohol intoxication in the elderly?
What medication can be initiated for an 18-year-old patient with suicidal ideation and depression?
What medication is recommended for a 30-year-old female with a history of migraine and Generalized Anxiety Disorder (GAD) for short-term flight anxiety, currently taking cholecalciferol (Vitamin D-3), cyclobenzaprine (Flexeril), escitalopram (Lexapro), magnesium gluconate (Mag-G), norethindrone (Jencycla), riboflavin (Vitamin B2), rimegepant (Nurtec), and ubrogepant (Ubrelyvy)?
What medication is best for a 43-year-old with a Patient Health Questionnaire-9 (PHQ-9) score of 9 and a Generalized Anxiety Disorder 7-item scale (GAD-7) score of 14?
Can sertraline (sertraline) be prescribed for a 15-year-old patient with episodes of tachycardia and a normal sinus rhythm on electrocardiogram (ECG)?
What is the difference between an idioventricular rhythm and ventricular tachycardia (VT)?
What are the downsides to a Midazolam (Versed) sedation drip for a neonate?
What is the efficacy of a corticosteroid (steroid) injection in a clinical setting for an asthma exacerbation?
What alternative antibiotics can be used for a dental abscess if Augmentin (amoxicillin-clavulanate) is ineffective?
What are the common causes of lumbar (lower back) pain?
What causes morning and nocturnal hypertension (high blood pressure)?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question