Alcohol & Prozac®: What you need to know

Medical Review by Jennie Stanford, MD, FAAFP, DABOM

Summary

• Prozac® works by increasing your brain’s serotonin levels, but alcohol use can lower your serotonin levels over time. For this reason, drinking alcohol while taking Prozac® may make your medication less effective.
• Combining alcohol with Prozac® may also increase certain side effects—including nausea, vomiting, and diarrhea, which are also potential symptoms of alcohol poisoning.
• Alcohol causes liver damage, and Prozac® has also been linked to liver injury in rare cases. That means drinking while taking this medication might make you more likely to damage your liver than taking Prozac® or drinking alcohol alone.
• The safest option is to avoid alcohol while taking Prozac®. If you decide to drink anyway, keeping it in moderation is safer than drinking excessively—although you are still taking a risk.
• Some research shows that Prozac® may help reduce alcohol use in some people with depression. Always consult your healthcare provider before taking this medication and be honest with them about your lifestyle so they can give you appropriate guidance.

Learn how drinking could impact your experience with Prozac®

Prozac® is a branded form of the medication fluoxetine, which is commonly prescribed for depression and anxiety disorders. It belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs), which also include Lexapro® (escitalopram) and Zoloft® (sertraline).

If you take Prozac® or are considering it as part of your depression treatment plan, you may wonder whether it is safe to consume alcohol while using this medication. Below, Lemonaid Health explores how alcohol and fluoxetine may interact, what risks this combination can carry, and how you can work with a healthcare provider to make informed choices about drinking if Prozac® is prescribed to you.

The risks of combining alcohol & Prozac®

The patient information for Prozac® states clearly that you should not consume alcohol while taking this medication. Here are some of the primary reasons why drinking alcohol while taking Prozac® can be risky:

Reduced effectiveness of Prozac®

Fluoxetine works by increasing your brain’s serotonin levels. Serotonin is a neurotransmitter that plays an important role in your behavior, mood, and memory, as well as several other functions.

But research shows that alcohol can also influence your brain’s serotonin levels. Specifically, although drinking alcohol triggers a short-term release of serotonin, people who drink seem to have lower levels of serotonin overall. This could make medications like Prozac® less effective, since there’s less serotonin in your system to work with.

Increased risk of side effects

Some of the possible side effects of fluoxetine also overlap with the possible side effects of ethanol toxicity, also known as alcohol poisoning. The most common of these include nausea and vomiting, although alcohol can also contribute to gastrointestinal disorders that can result in diarrhea—another possible adverse reaction to Prozac®.

Potential liver problems

Your liver is responsible for processing alcohol—and this causes liver damage whenever you drink. Over time, this can cause various kinds of liver disease including cancer and cirrhosis.

However, fluoxetine has also been linked to liver damage in rare cases. Although it is not well-known how this happens, the fact that this risk exists suggests that your risk of liver failure might be higher if you combine alcohol and Prozac® than if you take either one alone.

Making safer choices about alcohol while taking Prozac®

Since the patient information for Prozac® explicitly warns against consuming alcohol while taking this medication, the safest amount to drink is none at all. If you do choose to drink alcohol while taking Prozac®, it is important to understand that you are taking on all the potential risks that come with it—including, but not necessarily limited to the ones listed above. The following strategies may help reduce these risks to some degree, but they will not eliminate them.

Limit your alcohol intake

Drinking less is always healthier than drinking more—so if you decide to drink while taking Prozac®, drinking in moderation may cause fewer problems than drinking excessively. But moderation looks different for males and females:

• Females: A maximum of one standard drink per day
• Males: A maximum of two standard drinks per day

Below is a chart showing what a standard drink is defined as. Just remember: there is no guarantee that these are safe amounts to drink while you’re taking Prozac®.

Can Prozac® help you drink less?

Some research suggests that Prozac® can help people with depression cut back on alcohol use. One study found that patients taking 20-40 mg of Prozac® per day drank less, drank less frequently, and indulged in fewer heavy drinking days over a 12-week period. Although there is no evidence that Prozac® can help people without mental health conditions reduce the amount of alcohol they drink, this information may help your healthcare provider determine whether Prozac® could be an effective medication for you.

Consulting your healthcare provider

Individual reactions to medication vary, and so do the different reasons people have for drinking alcohol. That’s why you should always have an honest discussion with a qualified medical professional before taking Prozac®, and be honest with them about your relationship with alcohol. Your provider will be able to look at your medical history, including any medications or substances you use, and determine whether or not Prozac® is clinically indicated.

Potential alternatives to Prozac®

If Prozac® does not look right for you, your healthcare provider may suggest alternative medications for depression. Here are some other commonly prescribed options:

• Escitalopram (Lexapro®)
• Sertraline (Zoloft®)
• Bupropion (Wellbutrin®)

Each of these medications works differently and has different potential side effects. Read more about finding the right depression medication here.

Learn more about Prozac® & your lifestyle with Lemonaid Health

Drinking alcohol while taking Prozac® may increase your risk of some side effects, prevent your depression symptoms from improving, and potentially harm your health. The safest course of action is to avoid drinking alcohol completely if you are taking Prozac®, and follow your healthcare provider’s instructions regarding this medication.

Lemonaid Health can help you find answers to your questions about Prozac® and other medications. Our network of U.S. based healthcare professionals can review your health history and provide personalized recommendations for depression treatment, which may include prescription medication in clinically indicated cases. Get started today and find the support you need to make meaningful progress.

Prozac® is a registered trademark of Eli Lilly and Company. Lexapro® is a registered trademark of H. Lundbeck A/S. Zoloft® is a registered trademark of Viatris Specialty LLC, a Viatris Company. Wellbutrin® is a registered trademark of GlaxoSmithKline LLC.