What Are the Risks of Combining Alcohol and Fluoxetine?

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.