Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 1/21/2022
If you use an SSRI such as sertraline (sold under the brand name Zoloft®), the Food and Drug Administration (FDA) specifically recommends against drinking alcohol while taking them.
Sertraline is a selective serotonin reuptake inhibitor, or SSRI. It’s used to treat major depressive disorder (MDD, or depression), posttraumatic stress disorder (PTSD), social anxiety disorder, panic attacks and obsessive-compulsive disorder.
With millions of prescriptions in the US alone, sertraline is one of the most widely used SSRIs on the market today.
If you’re prescribed sertraline and like to enjoy the occasional alcoholic beverage, you probably have some questions about the safety of drinking alcohol while using your medication.
Below, we’ve answered common questions about drinking alcohol while you use sertraline and the health risks it can create.
Spoiler alert: Sertraline (Zoloft) and alcohol don’t go together.
In general, drinking alcohol while you’re using antidepressants isn’t recommended, as doing so can increase your risk of side effects and potentially worsen your depression.
This is the case for sertraline. In fact, the FDA cautions in its documentation for Zoloft, a popular brand name version of sertraline, that the concomitant use (using at the same time) of sertraline and alcohol is not advised.
Like other SSRIs, sertraline is thought to work by increasing the total amount of serotonin that’s active in your brain and body. Serotonin is a neurotransmitter that’s involved in regulating your moods, feelings and levels of anxiety.
Sertraline’s effects on serotonin are important for treating depression and anxiety, as depressed people or people with anxiety disorders often have low levels of this neurotransmitter.
Interestingly, research shows that serotonin, along with other neurotransmitters, may also play a significant role in the intoxicating effects of alcohol. After drinking alcohol, serotonin metabolites in the body increase, suggesting that alcohol may stimulate an increase in serotonin levels.
This double increase in levels of serotonin, from both sertraline and from alcohol, may result in a higher risk of sertraline side effects.
Pfizer, the manufacturer of Zoloft (in which sertraline is the active ingredient), also recommends avoiding alcohol consumption while undergoing treatment with sertraline, as the two mixed may cause you to experience an increase in drowsiness.
While mixing alcohol and sertraline isn't a “hard no,” and people on this medication do mix it with alcohol, it's always best to always follow the user guidelines and your healthcare provider’s instructions when taking any medication.
When it comes to interactions between substances, most people are aware of the dangers that can stem from using several different medications together.
However, when it comes to alcohol, public perception is a little different. After all, beer, wine and liquor are all marketed as drinks. Since alcohol is just an ingredient, surely there’s no risk that it can interact with medication in the same way that other drugs can, right?
Not quite. In reality, alcohol is itself a drug, just like sertraline and other antidepressants. When multiple drugs are used at once, there’s always a potential risk of interactions that you need to be aware of.
When it’s used on its own, sertraline may cause side effects. Common side effects associated with sertraline use include:
Nausea and vomiting
Loss of appetite
Changes in body weight
Difficulty falling or staying asleep
Tiredness and fatigue
Reduced sex drive
Changes in sexual performance
In rare cases, sertraline may cause more serious side effects, including a higher risk of suicidal thoughts and/or behavior in children, teenagers and young adults.
Many of the potential side effects of sertraline are identical to the effects of alcohol, especially if it’s consumed in excess, such as during a night of heavy drinking. For example, it’s common to experience nausea, vomiting, headaches, dizziness and tiredness after consuming alcohol.
Drinking alcohol while you’re using sertraline may increase the severity of these side effects. For example, you may feel dizzy and more intoxicated due to the effects of both substances, even if you’ve only had a small or moderate amount of alcohol.
Even if sertraline doesn’t make the negative effects of alcohol more severe, it may increase the speed at which they develop.
Your risk of experiencing significant interactions may be higher if you’re prescribed a large dose of sertraline, such as the maximum 100 to 200mg per day dosage used to treat depression and some anxiety disorders.
Since drinking alcohol while using sertraline isn’t recommended, some people might conclude that the best approach is to skip their dose of sertraline before a night out drinking.
This is not recommended. If you take sertraline to treat depression or an anxiety disorder, you should take it exactly as your healthcare provider instructs you to, which generally means that you shouldn’t skip a dose.
While skipping a dose of sertraline might not seem like a big deal, the reality is that SSRIs and other antidepressants are most effective when they’re used consistently.
There’s also a possible risk of developing a condition known as antidepressant discontinuation syndrome, or antidepressant withdrawal syndrome, if you abruptly stop taking medication such as sertraline.
The symptoms of antidepressant discontinuation syndrome can vary, but many people develop fatigue, headaches, aches, sweating and other flu-like symptoms, as well as insomnia, nausea, imbalance and sensory disturbances.
Because of this, it’s important not to stop taking sertraline or other antidepressants suddenly to enjoy a night of drinking, or for any other reason.
If you want to stop using an antidepressant, you should talk to your healthcare provider. They’ll work with you to help you stop using your medication safely, typically by assisting you to slowly taper your dosage over the course of several weeks.
Even if you’re not prescribed sertraline, drinking alcohol generally isn’t a good idea if you have depression or an anxiety disorder.
Alcohol is a depressant that works by reducing activity in certain parts of your brain. It’s known to cause impaired brain function, and research suggests that drinking can make the symptoms of depression and anxiety worse.
In fact, research suggests that the more a person drinks alcohol, the greater their risk of dealing with major depression at some point in life.
The same link appears to exist for anxiety disorders. In fact, in a prospective study, researchers found that experiencing clinical-level anxiety or engaging in alcohol misuse increases the risk of developing the other.
Put simply, having an anxiety disorder is associated with an increased risk of excessive alcohol consumption, while excessive alcohol consumption is associated with an increased risk of being affected by anxiety.
Alcohol itself can cause or contribute to anxiety-like symptoms, especially if you have an alcohol use disorder. Alcohol withdrawal effects include anxiety, nervousness, depression, irritability and mood swings, as well as difficulty thinking clearly.
Put simply, drinking alcohol isn’t recommended for people with depression. Not only can alcohol make your depression worse, but it could also make the symptoms of anxiety, panic disorder or other mental health conditions more severe and troublesome.
Using sertraline or another medication for depression or anxiety doesn’t mean that you can’t still enjoy a night out with your friends. In fact, getting out and socializing with other people is often a good thing to do if you’re affected by depression or anxiety.
To avoid drinking alcohol during a night out, try letting your friends know that you’re not allowed to drink because of your medication. Letting people know that alcohol is off limits due to a factor that’s out of your control may help to prevent people from pressuring you to drink.
If you’d rather not talk about it, try choosing a non-alcoholic drink that looks like an alcohol drink, such as a non-alcoholic beer or a glass of soda.
If you’re currently prescribed an antidepressant medication, whether it’s Zoloft, generic sertraline or any other medication in this class, it’s important to avoid drinking alcohol.
Not only can alcohol increase your risk of side effects from sertraline, but it may also make your depression or anxiety worse.
If you’re invited to an event that’s likely to involve alcoholic drinks, keep taking sertraline as your healthcare provider prescribed and consider skipping the booze. Instead, opt for a non-alcoholic drink instead so that you don’t put your health at risk.
Our full guide to sertraline goes into more detail about how sertraline works to treat depression, obsessive-compulsive disorder and a variety of other conditions.
For more help with your mental health, you can connect with a licensed psychiatry provider from home using our online psychiatry service.
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