Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 20, 2026
Fact checked
Quick Summary
  • Antidepressants and alcohol are the two most widely used substances across the world.
  • Both are legal, relatively affordable, and easy to acquire and are commonly used in combination to tackle the symptoms of major depressive disorder.
  • Mirtazapine, in particular, is a popular antidepressant that alters the brain chemicals to uplift mood and control depressive thoughts.
Reading time: 8 min

Antidepressants and alcohol are the two most widely used substances across the world. Both are legal, relatively affordable, and easy to acquire and are commonly used in combination to tackle the symptoms of major depressive disorder. Mirtazapine, in particular, is a popular antidepressant that alters the brain chemicals to uplift mood and control depressive thoughts. Combining it with alcohol is not typically safe as alcohol affects the same brain chemicals differently. Consequently, this combination can bring about deadly complications, mainly if mediation is used before alcohol consumption.

Most experts strictly advise against combining mirtazapine and alcohol, as they may bring on a range of negative and severely debilitating consequences. Some of these mirtazapine and alcohol side effects include:

Impairment of Thinking and Alertness

A combination of alcohol and antidepressants like mirtazapine can severely affect an individual’s judgement, motor skills, reaction times, and coordination. The effects are much more intense than the ones experienced with alcohol consumption alone. Some users also report experiencing impairment in the ability to perform tasks that require attention and focus by inducing drowsiness.

Sleepiness

Mirtazapine and other antidepressants can cause sedation in the users, similar to alcohol. Hence, taking them together can intensify this side effect, making it impossible for the user to carry on with the day.

Heightened Anxiety or Depression

Drinking alcohol sometimes counteracts the benefits of mirtazapine and other antidepressants, making the symptoms of depression worse and much more challenging to control. Some people may report improvement in mood shortly after drinking alcohol; however, these effects are temporary and are soon replaced by worsening anxiety.

In addition to alcohol, many other types and categories of medications must not be combined with mirtazapine to avoid cross-interactions. These medications include the following:

Zolpidem

Zolpidem is commonly prescribed to individuals with sleeping difficulties. Belonging to the drug class of sedative-hypnotics, it works by slowing the brain’s activities to make sleep easily achievable. Combining zolpidem with mirtazapine can bring several side effects, including confusion, dizziness, and drowsiness.

Duloxetine

Duloxetine is another type of antidepressant medication prescribed to deal with depressive thoughts. It improves the levels of norepinephrine and serotonin in the brain to improve its functionality. Mixing it with mirtazapine is not advised as both increase serotonin levels, triggering serotonin syndrome. This syndrome is characterised by vomiting, stomach cramps, tremors, muscle spasms, diarrhoea, and blurry vision.

Trazodone

Tradozone is a serotonin modulator that works by improving the levels of this neurotransmitter in the brain to combat anxiety and depression. If tradozone and mirtazapine are taken together, the risk of serotonin syndrome is significantly increased. Other side effects of this combination may include excessive sweating, increased heart rate, shivering, and seizures. If necessary, both medications can be combined in low doses under professional supervision only.

Lexapro

As a selective serotonin reuptake inhibitor (SSRI), Lexapro can also lead to serotonin toxicity when combined with mirtazapine. Serotonin toxicity includes symptoms like fever, muscle rigidity, extreme changes in blood pressure, and headache. Without urgent treatment, it may prove fatal.

Alprazolam

Alprazolam is the most popular medication for generalised panic disorders and anxiety. Belonging to the drug class of benzodiazepines, it enhances the binding of GABA, an inhibitory neurotransmitter, in the brain to induce a calming effect. Mixing it with mirtazapine must always be done after consulting with a doctor and considering the potential side effects, including impaired motor coordination, drowsiness, and difficulties with concentration.

Sertraline

Sertraline is a famous antidepressant used to manage panic attacks, anxiety, fear, and depression. As an SSRI that stops the reuptake of serotonin and accumulates it in the brain, it is commonly combined with mirtazapine to aid depression treatment. However, side effects like blurry vision, shivering, and sweating may occur because of the possibility of interaction.

Bupropion

As an atypical antidepressant, bupropion helps in the management of mood disorders. Inside the brain, it boosts dopamine and norepinephrine levels to improve users’ focus and concentration. Using bupropion with mirtazapine can increase the risk of suffering from seizures.

Living with depression or treating it can be highly exhausting. For many, it is not unnatural to want to drink alcohol as a solution to unwind and calm down a depressed mind. However, it is equally essential to ensure no harm in combining alcohol with any antidepressant you might be taking, such as mirtazapine. Mixing a new prescription with alcohol use before you are aware of the possible consequences may lead to disastrous consequences that may only leave you repenting.

If you or someone you love are fighting depression and seem to be struggling with alcohol, know that help is available. The first and the most critical step is always to acknowledge the problem and seek help from the right place. Many treatment providers and rehabilitation centres are working all across the UK to help people fight multiple psychiatric disorders simultaneously. Specialised care plans, known as dual diagnosis programmes, are offered to such individuals so they can recover from alcohol addiction and depression simultaneously.

Some common elements of a dual diagnosis program include:

  • Detailed assessments, including medical, psychiatric, psychological, and pharmacogenetic evaluations to establish accurate diagnoses
  • Cognitive behavioral therapy (CBT)to address underlying alcohol addiction and associated behaviours
  • Solution-focused brief therapy (SFBT) on finding solutions tailored to your individual goals and concerns
  • Brief strategic family therapy (BSFT) to fight addictive behaviours and co-occurring psychiatric illnesses with the support and help of families
  • Eye movement desensitisation and reprocessing therapy (EMDR) to deal with trauma-triggered depression and alcohol abuse
  • Psychoeducational groups enlighten patients on the nature of their underlying issues and provide them with tools to handle the stresses leading to these issues
  • Outdoor therapy to promote wellness and harmony in the mind and body
  • Neurofeedback that aims at self-regulation for better brain function and activity
  • Meditation and yoga restore the connection between the mind and the body to ensure mental healing

Help is just one click away. Give us a call to begin your journey with us today.

FAQs

What is the association between alcohol abuse and depression?
Depression is a debilitating psychiatric disorder characterised by low moods, loss of interest in usual hobbies, and hopelessness. In some individuals, these symptoms become so intense that they may resort to using alcohol as self-medication to fight them. While occasional drinking is not a matter of concern, heavy use of alcohol can lead to the development of addictive behaviours. This combination of issues can prove dangerous due to the severe problems of mixing alcohol with antidepressants.
Is mirtazapine a benzodiazepine?
No, mirtazapine belongs to the drug class of tricyclic antidepressants (TCAS) that work by blocking the reuptake and absorption of serotonin from the brain. This medication also blocks the reabsorption of neurotransmitters apart from serotonin which may sometimes lead to unwanted side effects.
Is mixing alcohol with mirtazapine a sign of alcohol addiction?
Mixing alcohol with mirtazapine can sometimes indicate a much deeper problem. People with untreated depression are at a heightened risk of indulging in alcohol addiction or abuse. Such people may be tempted to mix their medications, such as mirtazapine, with alcohol to escape the emotional pain or simply get high and enjoy it. Irrespective of the causative factor, these people may even stop taking mirtazapine to drink more. However, sudden withdrawal from antidepressants can lead to serious side effects, such as seizures, self-harm, and suicidal ideations.
Who is at the most risk of combining mirtazapine and alcohol?
An individual with untreated depression or substance abuse is at an exceptionally high risk of abusing alcohol alongside taking mirtazapine and other prescription medication. Because this combination can make the user sleepy, people with insomnia and other sleep-related difficulties may also use the two substances together to find quick relief. However, indulging in this potentially dangerous habit can lead to more intense problems in the long run.
When should I seek help with mixing mirtazapine and alcohol?
If you are combining mirtazapine with alcohol to get high and are experiencing the consequent adverse effects, getting help from a qualified expert is highly recommended. Engaging in risky behaviours like the one described before can be a sign of addiction warranting immediate treatment. The best place to seek help and support is an inpatient rehabilitation center that can effectively manage alcohol abuse while assisting a person with their depressive symptoms. Such centres provide people with easy access to trained and highly-qualified therapists, doctors, and other staff members to monitor their mirtazapine use and help them manage depression and alcohol addiction side by side. This integrated care plan often continues after your treatment tenure finishes at a rehab.
Is it always dangerous to mix alcohol and antidepressants?
No, combining alcohol with antidepressants is not always as dangerous. In fact, some antidepressant medications are known not to interact dangerously with alcohol. Also, some of them, like mirtazapine, may not harm the body if combined with light drinking. However, it is still advised not to combine them with alcohol unnecessarily for your safety.
Can you overdose on mirtazapine with alcohol?
Alcohol can easily trigger an overdose of mirtazapine if taken together, and this is because both similarly affect the brain and may enhance each other’s effects on the brain. Moreover, alcohol may also interrupt the breakdown of mirtazapine, allowing it to accumulate in the body and exert much more potent effects. Some common signs of mirtazapine overdose include:
Drowsiness
Weight gain
Trouble concentrating
Constipation
Abdominal pain
Diarrhoea
Vomiting
Strange dreams
Body aches

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