If you drink alcohol, and you are not taking medication, you should not exceed the recommended daily amounts of between 3-4 units, for men, and between 2-3 units, for women. One unit of alcohol is equal to half a pint of normal strength beer, one glass of wine, or a single, shot of spirits.
The main groups of
- selective serotonin re-uptake inhibitors (
SSRIs) - for example, fluoxetine,
- tricyclic antidepressants (TCAs) - for example, amitriptyline, and
- monoamine-oxidase inhibitors (MAOIs) - for example, phenelzine.
There are also some newer antidepressants which do not fit into the above groups; they include venlafaxine, mirtazapine, and reboxetine.
Selective serotonin re-uptake inhibitors (
Some evidence shows that fluoxetine does not produce side effects (interact) with alcohol. Similarly, sertraline, paroxetine or citalopram seem unlikely to significantly increase any side effect associated with drinking alcohol. However, there may be a slight increase in the effects of alcohol if you are taking fluvoxamine.
SSRIs recommend that alcohol should be avoided while you are taking these medicines because, like all antidepressants, they can adversely affect your performance of skilled tasks, such as driving, and operating machinery.
Tricyclic antidepressants (TCAs)
If you are taking TCAs (particularly amitriptyline) and you drink alcohol, it can cause
drowsiness and a decrease in your co-ordination. The effect is usually worse during the first few weeks after you start to take TCAs. Increased
drowsiness is also possible with related antidepressants, such as mianserin, maprotiline and trazodone. It is therefore sensible not to drink alcohol for at least the first few weeks when you start taking TCAs in order to assess your reaction to the potential side effects.
Monoamine-oxidase inhibitors (MAOIs)
If taken with tyramine, MAOIs can produce serious side effects, such as a sudden and dangerous rise in your
blood pressure. Tyramine is a protein found in food and many alcoholic drinks.
It is best to avoid alcohol if you are taking an MAOI. However, if you do decide to drink, you should follow the guidelines outlined below:
- Avoid drinking Chianti, home made beers and wines, real ales and red wines, as these all contain tyramine.
- You can drink white wine, and non-alcoholic beer, but make sure that you do not drink more than one or two units a day - that is, one or two glasses of wine, or a pint of beer .
- Gin, vodka, and other clear spirits are fine, but you should only drink them in true moderation - that is, one or two ounces a day.
If you are taking moclobemide, which is a Reversible Inhibitor of Monoamine Oxidase (RIMA), you are unlikely to experience adverse side effects if you drink alcohol.
Venlafaxine does not significantly increase the co-ordination problems associated with drinking alcohol, and neither does reboxetine. However, the manufacturers of venlafaxine still advise you to avoid drinking alcohol, when taking this medication.
Mirtazapine has been shown to increase co-ordination problems after drinking alcohol, and it can also make you feel sleepy. Therefore, performing skilled tasks, such as operating machinery, or driving motor vehicles, is dangerous. The manufacturer advises you to avoid drinking alcohol, while taking mirtazapine.