Why It's Dangerous to Mix Alcohol with Medications for Mental Illness

Gillian May


Photo by Anna Shvets from Pexels

My father died almost five years ago from liver failure due to alcoholism. He also struggled with a horrible depression that went on for most of his life. My father didn’t get a little down; he lost all ability to function when he was depressed. And, of course, the more depressed he got, the more he drank. He also took several medications for his depression.

As for me, I followed in my father’s footsteps with depression and alcoholism as well. I spent the better part of my adult years depressed and drunk. I write about this story a lot, but I leave out one piece of information. This is because it requires a whole article on its own.

The truth is, if you have depression or any mental illness — mixing booze and mental health medication is dangerous for many reasons. I’m very confident my father’s death was sped up by his mixing alcohol and pills. As a former mental health nurse, I knew that combining the two was bad, so guess what I chose? Booze.

Mixing alcohol and mental health medication is very problematic, and I’ll attempt to explain why. This is for anyone who wants to understand more about medications and co-occurring mental health and addiction issues. Even though there are warnings on medication packages and doctors and pharmacists usually counsel people not to mix meds and booze, people still don’t know why this is a problem.

1. Both mental health medications and alcohol are hard on the organs, especially the liver.

The main reason why health professionals counsel not to mix booze and meds is due to the toxic effect they have on the body. Most medications are metabolized through the digestive system. Many drugs are toxic to the liver. However, mental health medications, in particular, tend to be especially harmful. Most of the time, the liver can take care of it, but up to a certain point.

One of the first things the liver prioritizes when doing its job is toxic substances. The liver will divert all energy towards this and will fall behind on its other jobs. The liver has a hard enough time trying to metabolize alcohol. Still, when you add medications to the mix, it increases this difficulty.

A few things happen when the liver has to work hard to metabolize both alcohol and medications.

  • One, levels of either alcohol or medications may reach toxic levels in the blood, depending on the medication. This is because the liver may be overwhelmed by trying to work on both substances.
  • The liver reduces its workload on other bodily priorities like digestion, nutrient absorption, and creating substances the body needs for blood and enzyme production.

Therefore, mixing meds and alcohol can increase the chances of liver damage and health issues from a liver that can’t do its job correctly. Medications used for psychosis are hazardous for the liver.

2. Mixing alcohol and mental health medications increases serious side effects.

As I mentioned above, the body has to work hard to process two toxic substances, which puts pressure on many organs. Because of this, the side effects of both alcohol and the medication can increase dramatically.

The most notable side effect is drowsiness. The most common consequences are falls or injuries from extreme drowsiness or dizziness. While rare, it’s possible to get so drowsy that a person can asphyxiate from respiratory arrest. This is more likely to happen when other medications are added.

Unfortunately, once people develop alcohol tolerance, they feel these mixtures are safe. Thus, they may end up consuming more medications or drugs, thinking it’s ok. Even adding cough medicine on top of alcohol and mental health medications can cause extreme side effects and overdose.

Lastly, some studies suggest that alcohol and mental health medications may increase the potential for violent behavior, more excessive alcohol use, and conditions such as rhabdomyolysis (a breakdown of muscle tissue). And for those taking MAO inhibitors, mixing alcohol can cause a fatal reaction.


Photo by Chris F in Pexels

3. Mixing alcohol and mental health medications decreases the effect of the medicine.

This one is poorly understood by most people. Also, few doctors and pharmacists emphasize this issue because it may happen to some people yet others manage ok. But the fact is that alcohol can decrease the effectiveness of certain medications used to treat mental illness.

Medications used for depression, such as SSRI’s are particularly at risk, and the information given by health authorities is mixed. This is because some people are unaffected by mixing booze and SSRI’s yet others are highly affected. But research shows that SSRIs coupled with alcohol can decrease the effectiveness of the medication.

Most people understand that depression can wreak havoc on a person’s life. Depressed people are much more likely to abuse alcohol as they perceive the initial calming effects as self-medicating.

However, alcohol will worsen depression and actually causes anxiety. But most people don’t realize that their antidepressants are not working, which is why they continue to feel depressed. Unfortunately, this can lead to a dangerous cycle of alcohol use and severe depression, which is what happened to my father.

The same caution should be applied to medications used for psychotic disorders. Firstly, alcohol can increase episodes of psychosis even without medication use. Secondly, the use of alcohol can decrease the effectiveness of the medications leading to more psychotic episodes.

Overall, there seems to be a general message that combining mental health medications with alcohol is not a good thing, but there’s limited education about why that is. Hopefully, this article clears that up for anyone curious to know more about this topic.

Another reason why more stern warnings are lacking may be that those who take mental health medications are already in a tough place. Like me, they may choose booze over medications, which can be dangerous for the mental health condition even though alcohol is also dangerous.

Unfortunately, some people who have mental health issues become addicted to alcohol and are unable or unwilling to stop. So they may just keep drinking and forgo the meds. Also, telling people to stop drinking may exacerbate mental health issues and the incidence of dangerous withdrawals. It’s understandable now why this issue can be so complex.

In this case, doctors have to give advice on a case-by-case basis. However, most doctors agree that those who take mental health medications need to stay with the safe drinking guidelines, which is 1 drink a day for women and 2 drinks a day for men. Anything beyond the safe drinking guidelines is hazardous for those with mental health issues who take medications.

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I'm a former nurse turned freelance writer. I have extensive experience in administration, frontline care, and education in mental health, public health, and geriatrics. However, after 20 years, I needed a change and always wanted to write. I have personal and family experience in mental health and addictions, so I'm passionate about advocacy and education in those areas. I'm also a traveler, photographer, and artist. I funnel all my various expertise into my writing and hope to provide valuable content that is entertaining and educational. Join my email list if you want to read more of my work - https://upbeat-trader-4181.ck.page/839d0ab3f9.


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