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What Are the Risks of Combining Alcohol and Fluoxetine?

Tricia Christensen
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Updated: May 17, 2024
Views: 15,122
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The risks of combining Prozac® or fluoxetine and alcohol aren’t fully understood. Most doctors advise against mixing these two substances for two different reasons. Alcohol and fluoxetine may increase the sedating, cognitive-impairing, and motor impairment properties of each other, and they act in opposite ways, which can render Prozac® less effective. Also, many people taking Prozac® are at higher risk because they take other drugs that negatively conflict with alcohol consistently. Encouraging research suggests that fluoxetine may help in alcohol abstention.

Research on alcohol increasing Prozac®'s side effects isn't always consistent. Some studies conclude that people using both are more likely to encounter higher sedation levels, greater cognitive impairment, and reduction in motor skills, such as those used to drive a car. Opposing studies show no specific effect. It’s possible that people with a higher degree of side effects will see these side effects climb when they combine alcohol and fluoxetine. Many doctors recommend the drugs not be used together for this reason, and others suggest that occasional minimal usage of alcohol isn’t dangerous for fluoxetine users.

Predictably, the problem escalates when alcohol and fluoxetine are combined with other behavioral medications. Alcohol use is strongly discouraged with tranquilizers, antipsychotic medications, and many mood stabilizers and anti-convulsants. The likelihood that Prozac®, alcohol, and other medications will create problems increases with each new substance, and many people taking medications for depression or anxiety disorders are on more than one medication.

Another compelling reason to avoid alcohol and fluoxetine use lies in the fact that these substances achieve opposite effects. Fluoxetine is an antidepressant that acts on serotonin receptors to prevent them from using the circulating serotonin in the brain, thereby creating a higher supply of free serotonin, which can elevate mood or reduce anxiety. Alcohol is a depressant that interferes with serotonin production and that can, over time and with higher use, increase anxiety by impairing processes of the body that help regulate it.

Medications being taken to reduce anxiety or depression are less effective when combined with alcohol. Sometimes this effect isn’t noted right away, and initially, alcohol use may seem to make a problem better. Over time, the problem typically worsens, and people may try to solve that problem by drinking more. Depression and anxiety conditions correlate to a high level of alcoholism, which tends to exacerbate these conditions rather than helping them, and any antidepressant may be ineffective if it is combined with frequent alcohol use. In other words, alcohol use may prevent people from getting better on a medication like Prozac®.

Interestingly, numerous studies on alcohol and fluoxetine suggest the first may be helpful in not using the second. Fluoxetine and several other antidepressants can be used to promote comfort in recovery from drinking and sometimes from drug use. That fluoxetine may inhibit the desire for drinking and make people feel better without it, suggests that people using it may find it easier not to combine fluoxetine and alcohol, and in this choice, they may experience better symptom control.

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Tricia Christensen
By Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a WiseGeek contributor, Tricia Christensen is based in Northern California and brings a wealth of knowledge and passion to her writing. Her wide-ranging interests include reading, writing, medicine, art, film, history, politics, ethics, and religion, all of which she incorporates into her informative articles. Tricia is currently working on her first novel.

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Discussion Comments
By literally45 — On Mar 05, 2014

I think everyone needs to decide for themselves whether they are able to combine alcohol and fluoxetine safely. Of course, a doctor should be advised. I would not try to mix them if my doctor told me that I absolutely can't.

Having said that, everyone is on a different dose of fluoxetine and we all have different physical sensitivity to drugs and alcohol. Someone who is very sensitive to both and who is already experiencing fluoxetine side effects should not try alcohol. But someone who has a very high tolerance to drugs and alcohol, may have a very small amount. It's important to make sure that there are people who can help in case things don't work out well and there are side effects. And a safe ride home should always be arranged. Sometimes it's difficult to guess how our body will react to a drug. So it's important to take it easy. The best thing to do is to just avoid the alcohol.

By SteamLouis — On Mar 05, 2014

I don't know how people can drink alcohol while on fluoxetine. I was on the medication for several years, at the lowest dose and it made me constantly sleepy and drowsy. I used to have several coffees during the day and still would have to take a nap as soon as I got home from work. If I drank alcohol on top of it, I'm sure I would not be able to wake up for days. Fluoxetine's major side effect is sedation. Alcohol can act like a sedative too and it's never a good idea to mix different sedatives.

By fBoyle — On Mar 05, 2014

I'm on fluoxetine and I drink once a week on the weekend. And on that day, I only have a few mild drinks. I have not experienced any negative side effects.

Tricia Christensen
Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a WiseGeek contributor, Tricia...
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