Medical professionals generally advise against drinking alcohol while taking sertraline (Zoloft). Though each person metabolizes medication and alcohol differently, the interaction can be very dangerous and even life threatening.

Zoloft belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRI). They work by blocking the brain’s serotonin receptors, causing more serotonin molecules to circulate.

Serotonin stabilizes a person’s mood and is known as the “feel-good” hormone. Having more of this hormone in the brain can benefit mood, sleep, and emotions.

Anyone taking any medication should try to prevent drug interactions. If a person is taking Zoloft, they should avoid drinking alcohol.

This is because alcohol temporarily increases serotonin levels. It also has some of the same side effects as Zoloft. Having the drug and alcohol in the body can be dangerous. In some people it can, for example, cause oversedation and a higher risk of suicidal behavior.

Below, learn more about the risks of consuming alcohol while taking Zoloft.

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In short: No. There are various classes of antidepressants, but doctors generally do not recommend having any alcohol when taking these medications.

However, some people who take Zoloft find that they can drink small amounts of alcohol without negative effects. An older study found that the combination did not cause significant impairment. But a 2014 study showed that it increased memory impairment, impulsivity, and violence in some people.

It is impossible for a doctor to estimate how much alcohol might be safe for someone taking Zoloft. Each person metabolizes alcohol and antidepressants differently, and a safe amount for one person may not be safe for another.

If a person does decide to drink while taking Zoloft, they should do so with caution, and stop consuming alcohol if any adverse effects develop.

Drinking alcohol while using Zoloft can have various effects, including:

Serotonin syndrome

As an SSRI, Zoloft blocks the normal uptake of serotonin, which increases the amount of serotonin in the brain.

Alcohol can also temporarily boost the amount of serotonin in the brain. Consuming alcohol while taking antidepressants can lead to very high serotonin levels.

Excess serotonin can cause serotonin syndrome, a potentially life threatening condition. It may cause a rapid heart rate, a coma, and hallucinations.

Suicidal thoughts and behavior

One possible side effect of Zoloft is an increase in suicidal behavior and thinking. This is serious, and it can heighten when a person taking this medication also consumes alcohol.

The interaction can cause depression, which may hinder the effectiveness of an antidepressant. The combined effects can make a suicide attempt more likely.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

Oversedation

Both Zoloft and alcohol are central nervous system depressants, meaning that they slow or suppress brain activity. In combination, the two can cause oversedation. This can be dangerous, and in severe cases, it can cause slowed breathing, coma, and death.

Also, alcohol and antidepressants can each cause drowsiness, reduced alertness, and uncoordinated movements. When a person has both in their system, these effects increase, which may lead to accidents and injuries.

Toxicity

If a person taking antidepressants consumes too much alcohol, their liver may be unable to process the toxins. This can result in toxicity or liver damage.

Zoloft can interact with the following drugs:

  • Monamine oxidase inhibitors (MAOIs): This is another class of antidepressants. MAOIs work differently from SSRIs, and a person should not take them together. If a person is switching between types of antidepressants, they should only do so with a doctor’s guidance. Symptoms of an MAOI and SSRI interaction include:
    • rapid fluctuations in heart rate, respiration, and blood pressure
    • confusion
    • extreme agitation
    • delirium
    • coma
  • Warfarin (Coumadin) and digitoxin (Crystodigin): These two drugs are blood thinners. They bind to plasma proteins, and they can cause adverse effects if someone takes them with Zoloft.
  • Pimozide (Orap): Doctors often use this antipsychotic drug to treat Tourette’s syndrome. In combination with Zoloft, it can cause cardiac side effects.
  • Serotoninergic drugs: These increase serotonin levels in the brain, like Zoloft. The combination can lead to serotonin syndrome.

Zoloft can also interact with other drugs and supplements. A person should let their doctor know about any drugs or supplements that they take before starting Zoloft treatment.

Caffeine is in coffee, teas, and sodas, and it may enhance the effects of antidepressant medications, though confirming this requires more research.

A 2017 clinical trial found that caffeine increases the effectiveness of antidepressant medications in rodents. To determine if it affects humans in a similar way, the authors tested it on 95 male participants who took antidepressants.

They divided the participants into three groups and compared the effects of: a placebo, 60-milligram (mg), and 120-mg caffeine pills. After 4 weeks, the group taking the 60-mg dosage experienced faster antidepressant effects and improved thinking ability. The authors concluded that supplementing antidepressants with caffeine may enhance treatment outcomes.

The Food and Drug Administration (FDA) warns against drinking alcohol while taking Zoloft because the two can cause similar side effects and dangerous interactions.

Moreover, alcohol can worsen the symptoms of depression, which may make any antidepressant less effective and increase the risk of suicidal behavior.