Can I Take Lexapro (Escitalopram) After a Few Drinks?

Hi there! Thanks for reaching out to us. This is a great question, and one we get often from people in their first week or two of treatment.

The short answer is that you should most likely take your medication as prescribed, which means taking your usual 5 mg dose tonight.

A few drinks and a starting dose of Lexapro should not cause a dangerous reaction together. The concern is that both can make you drowsy, dizzy, and less sharp, so tonight is about taking it easy, not skipping your medication.

Below, I'll go over what the prescribing information says, why alcohol isn't recommended with Lexapro, and what this means for you going forward.

What the Prescribing Information Says

The prescribing information for Lexapro (escitalopram) addresses alcohol directly:

Although Lexapro did not potentiate the cognitive and motor effects of alcohol in a clinical trial, as with other psychotropic medications, the use of alcohol by patients taking Lexapro is not recommended.

The Medication Guide that comes with your prescription puts it more simply: "Do not drink alcohol during treatment with Lexapro."

A few things stand out here. First, there is no known chemical interaction between the two.

Lexapro doesn't cause a sudden, severe reaction with alcohol the way some medications do (metronidazole is a common example), and in the clinical trial referenced above, Lexapro did not make alcohol's effects on thinking and coordination any worse.

However, the manufacturer still says not to drink.

That is because the effects of the two can have certain additive effects. Lexapro can cause sleepiness and may affect your ability to think clearly, make decisions, or react quickly. Alcohol does the same, so together they can leave you more impaired than either one alone.

What to Do Tonight

Take your 5 mg dose at your normal time, the same as any other night. Skipping it doesn't make the alcohol any safer, and it just adds a falling drug level to the mix. Beyond that:

• Skip any more drinks tonight and have a glass of water.
• Don't drive, and get up slowly from a bed or chair in case you feel lightheaded.
• Tomorrow, take your next dose at your normal time. There is nothing to make up or adjust, and never double up.

If at any point tonight you feel unusually drowsy, confused, or have trouble staying awake, call Poison Control (1-800-222-1222) or seek medical care. That would be unexpected with a few drinks and a 5 mg dose, but it's worth knowing where the line is.

Why Alcohol Isn't Recommended With Lexapro - Details

Beyond the added drowsiness and dizziness, there are a few reasons this matters more in your situation than it might for someone who has been on Lexapro for a year.

You're in your first week. Side effects like nausea, drowsiness, and dizziness tend to be most noticeable during the first one to two weeks and usually fade as your body adjusts. Alcohol can amplify all of them.

Alcohol works against the reason you started Lexapro. Alcohol disrupts sleep and often increases anxiety the next day, which makes it hard to tell whether the medication is helping. Lexapro typically takes several weeks to reach its full effect for anxiety, so steady days now make it much easier to judge how well it is working.

Alcohol itself can worsen mood. Heavy or regular drinking is linked to worse anxiety and depression, and it can get in the way of treatment working the way it should.

What About Drinking While Taking Lexapro Going Forward?

One night like this is not a reason to stop or skip your medicine. If you expect to drink now and then, bring it up with the doctor who prescribed Lexapro.

Many prescribers are comfortable with an occasional drink once you're past the adjustment period and doing well, but that is a decision for the two of you to make together, and it depends on how much and how often you drink. Be honest about that. It helps them give you an answer that fits your situation rather than a blanket "no."

One thing not to do is skip doses on days you plan to drink. Missing doses makes Lexapro less effective, can bring on discontinuation symptoms once you're on a steady dose, and doesn't make the alcohol any safer.

Final Words

You did the right thing by stopping to ask before taking your dose.

Starting a medication for anxiety takes some patience, and the first few weeks are often the hardest part. We're glad you're giving it a fair try. Tonight, take your dose, drink some water, and get some rest.

Thanks again for reaching out to HelloPharmacist.