Antidepressants and alcohol are the two most widely used substances across the world. Both are legal, relatively affordable, and easy to acquire but alcohol is not a treatment for 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 can increase drowsiness and impair thinking and coordination. The prescribing information advises avoiding alcohol; taking the two at different times does not reliably prevent an interaction.
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 judgment, 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, several medicines interact with mirtazapine. Some combinations are contraindicated, while others require an individual prescribing decision and monitoring. Discuss routine medication changes with your prescriber; suspected serotonin syndrome needs immediate action as described below. Medicines to review 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. Combining duloxetine with mirtazapine increases the risk of serotonin syndrome and requires prescribing review and monitoring. Possible signs include fever, confusion, marked agitation, muscle rigidity, tremor, and seizures. If serotonin syndrome is suspected, stop mirtazapine and seek emergency medical care.
Trazodone
Tradozone is a serotonin modulator that works by improving the levels of this neurotransmitter in the brain to combat anxiety and depression. Taking trazodone and mirtazapine together can increase the risk of serotonin syndrome. Other side effects of this combination may include excessive sweating, increased heart rate, shivering, and seizures. Any combined prescription needs individual assessment and monitoring; a low dose does not eliminate the interaction risk.
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 generalized 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. The mirtazapine label advises avoiding benzodiazepine combinations because they increase impairment. If you already take alprazolam regularly, ask your prescriber to review the combination; do not abruptly stop alprazolam without a clinical plan.
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, its combination with mirtazapine requires an individual prescribing decision and monitoring for serotonin syndrome. 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. Avoid alcohol while taking mirtazapine. If you are dependent on alcohol, get medical help before abruptly stopping or reducing drinking; severe confusion, hallucinations, or a seizure during withdrawal require emergency care. 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 centers are working all across the UK to help people fight multiple psychiatric disorders simultaneously. Specialized care plans, known as dual diagnosis programs, 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 behaviors
- Solution-focused brief therapy (SFBT) on finding solutions tailored to your individual goals and concerns
- Brief strategic family therapy (BSFT) to fight addictive behaviors and co-occurring psychiatric illnesses with the support and help of families
- Eye movement desensitization 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.


