Amitriptyline and Alcohol: What Are The Risks?

If you have a mental illness such as major depressive disorder (MDD) or anxiety, you already have a lot to juggle. 

Between the realities of your symptoms and the potential adverse effects of medications such as amitriptyline, there’s a lot to manage without even thinking about the effects of treatment on your social life.

If you’re prescribed amitriptyline, you may have questions about the safety of drinking alcohol while you’re using your medication.

Combining amitriptyline and alcohol isn’t recommended. Not only can alcohol make recovering from depression more difficult, but it may also increase your risk of developing side effects from antidepressants such as amitriptyline.

This means that if you normally drink alcohol, you may have to make some adjustments to your lifestyle while you use amitriptyline to treat depression or a similar condition.

Below, we’ve explained what amitriptyline is, as well as how it works as a medication for clinical depression and other mental health conditions.

We’ve also covered what you need to know about amitriptyline and alcohol, from the health risks associated with drinking while using amitriptyline to simple techniques that you can use to avoid consuming alcohol while you’re treating depression. 

Finally, we’ve shared some other depression treatments that you may want to consider if you’re currently prescribed amitriptyline or feel worried that you could be depressed. 

Amitriptyline is a tricyclic antidepressant, or TCA. It’s approved by the FDA as a medication for treating major depression. Like many other antidepressants, amitriptyline is also used off-label to treat other conditions, including post-traumatic stress disorder (PTSD) and chronic pain. 

As a treatment for depression, amitriptyline works by increasing levels of the neurotransmitters serotonin and norepinephrine. 

These neurotransmitters are involved in regulating certain aspects of your moods, feelings and behavior. Research suggests that low levels of these naturally-occurring chemicals is linked to a higher risk of developing depression, anxiety and other mental health disorders. 

Amitriptyline is effective at treating depression. However, these days it generally isn’t used as a first-line medication (meaning the first type of medication prescribed to treat a condition) due to its high risk of causing side effects compared to newer drugs.

Potential side effects of amitriptyline include:

• Nausea

• Vomiting

• Drowsiness

• Confusion

• Dry mouth

• Headaches

• Physical weakness

• Unsteadiness

• Tiredness

• Confusion

• Nightmares

• Blurred vision

• Constipation

• Difficulty urinating

• Excessive sweating

• Changes in appetite 

• Changes in weight

Like other antidepressant drugs, amitriptyline can also affect your sex drive and sexual function, which may cause you to feel less interested in sexual activity.

Other side effects of amitriptyline include muscle stiffness and spasms, as well as blurred vision and eye pain caused by excessive pressure. 

When amitriptyline is used at the same time as other antidepressant medications, it may lead to serotonin syndrome -- a potentially dangerous interaction caused by high serotonin levels.

Almost all of us are familiar with the effects of alcohol, which can include changes in your mood, thoughts and behavior. Alcohol can cause you to feel far less inhibited, affect your memory and give you extra confidence in certain situations.

Alcohol consumption can also affect your physical and mental health, including by reducing your level of self-control, ability to think clearly and general physical coordination. 

Alcohol is many things, but most of us consider it a beverage first. However, it’s also a drug that is classified as a central nervous system depressant.

Alcohol essentially depresses -- or slows down -- your brain activity, which can cause significant changes in your physical and mental function. 

The number of drinks you have on any given night is a major factor in how severe the effects of alcohol will be. Moderate alcohol consumption for women is defined as just one alcoholic drink per day, so most social drinkers are already a couple past the recommendation.

Drinking alcohol while taking amitriptyline generally isn’t a good idea for several reasons. First, amitriptyline and alcohol have similar effects in your body, including sedative effects that cause you to feel drowsy and tired. 

In fact, because of its effects on alertness, users of amitriptyline are advised not to operate any motor vehicles or heavy machinery until they’re familiar with how it makes them feel.

When you drink while taking amitriptyline, you can increase the severity of these effects, which may affect your coordination, alertness and memory in ways you don’t expect.

This could increase your risk of injuring yourself by tripping, falling or bumping into things while intoxicated. You may also notice that you feel drunk faster than normal due to the combination of effects from amitriptyline and alcohol together. 

Put simply, drinking while you’re on amitriptyline could cause the effects of both substances to affect you more severely than normal, which could lead to serious issues.

In the most literal sense, any interactions between alcohol and amitriptyline aren’t likely to be deadly. However, the potential for nasty hangovers, falls and bruises, and risk of driving while impared can all make this a dangerous combination. 

It’s important to remember that your coordination and decision-making skills are both affected when you’re intoxicated, and that these effects may occur sooner or feel more severe if you’re also taking amitriptyline.

This doesn’t just increase your risk of embarrassing yourself in front of other people or texting your ex at a bad time -- it also means you’re more at-risk of making reckless decisions during the time you’re under the influence. 

Because of the risks and negative effects associated with combining amitriptyline and alcohol, it’s best to avoid drinking entirely while you’re prescribed this medication.

If alcohol is a normal part of your life -- for example, you’re a social drinker who goes out with friends on a weekly basis -- reducing your alcohol consumption all the way to zero may not be easy. However, it is something that you can do by making changes to your daily habits.

Try the following techniques to avoid alcohol and reduce your risk of experiencing any harmful effects while using amitriptyline:

• Go out and have fun, but try switching to a non-alcoholic drink. You don’t have to stay home to avoid drinking. If you feel in control of your drinking habits, try making the switch to non-alcoholic drinks while you’re taking amitriptyline.
  If you want to avoid any awkward conversations or pressure to drink, discreetly order a non-alcoholic drink that looks like it contains alcohol, like a non-alcoholic beer, glass of soda or mocktail. 

• Let your friends know why you can’t drink. If your friends are accepting, try talking to them about why you’re taking antidepressants and why it’s important for you not to drink any alcohol during treatment.
  Your friends might understand your situation more than you’d think and can help you by preventing you from accidentally drinking while you’re out together. 

• If you have a substance use disorder, let your healthcare provider know. Alcohol is an addictive substance for many people. If you’re dependent on alcohol, it’s important to let your healthcare provider know before you start using amitriptyline.
  Depending on the severity of alcohol dependence for you, your healthcare provider may suggest taking part in a treatment program before using amitriptyline. 

Whatever you do, it’s important not to stop taking amitriptyline just so you can go out and enjoy a night of drinks with friends. 

Not only can drinking alcohol interfere with the treatment of depression, but stopping treatment with amitriptyline suddenly can result in a serious risk of you dealing with withdrawal symptoms, including nausea, headaches and reduced energy levels.

Because of this, it’s important to only stop taking amitriptyline under the supervision and care of your healthcare provider. 

If you feel tempted to drink, or find it difficult to reduce your alcohol intake, don’t stop using your medication. Instead, reach out to your healthcare provider to let them know that you need a little extra assistance.

As a tricyclic antidepressant, amitriptyline generally isn’t used as a first-line treatment for clinical depression. 

Instead, newer classes of antidepressants, like selective serotonin reuptake inhibitors (SSRIs) serotonin-norepinephrine reuptake inhibitors (SNRIs) are generally prescribed first to manage depressive symptoms.

These medications are roughly as effective as amitriptyline, but have a lower risk of producing extra side effects. 

If you’re prescribed amitriptyline and think it might not be the right medication for you, you may want to talk to your mental health provider about switching to a newer medication.

We offer several SSRIs online, including fluoxetine (Prozac®), paroxetine (Paxil®), citalopram (Celexa®), sertraline (Zoloft®) and escitalopram (Lexapro®).

We also provide several SNRIs and atypical antidepressants, including duloxetine (Cymbalta®), venlafaxine (Effexor®) and bupropion (Wellbutrin®).

These medications may be a better choice for you if you’re prone to common side effects while using amitriptyline. 

However, like amitriptyline, they’re not safe to take with alcohol, meaning you’ll still need to cut down your alcohol intake if you’re prescribed any type of SSRI or SNRI to treat depression.

In addition to medication, other treatment approaches can help you to handle the symptoms of depression and make better progress towards recovery.

These include cognitive behavioral therapy (CBT), as well as lifestyle changes such as getting plenty of exercise, spending time with your friends and family, following a consistent schedule, eating a balanced diet and avoiding nicotine, stimulants and other drugs.

Our list of ways to help depression goes into more detail about these approaches, from talking to a therapist to changing your habits and daily life. 

We offer therapy online, allowing you to easily access help from the privacy of your own home, all without any need to travel to and from your appointments. 

Drinking alcohol while using antidepressants isn’t recommended, and tricyclic antidepressants like amitriptyline are no exception.

Not only can amitriptyline’s potential interactions with alcohol affect your health and wellbeing, but the effects of alcohol may make your depression symptoms more severe.

Try to avoid drinking alcohol while using amitriptyline for the entire duration of treatment. If you have an alcohol use disorder, or simply find limiting your alcohol intake difficult, make sure that you let your healthcare provider know as soon as you can.

Amitriptyline is one of several medications available to treat depression. We offer a wide range of evidence-based medications for depression and anxiety through our psychiatry service, with prescriptions available following an online consultation with a licensed psychiatry provider.

You can also learn more about dealing with depression using our online mental health services, as well as our free mental health resources and content.