The Risks of Combining Zoloft and Alcohol

Alcohol and Zoloft

Antidepressants like Zoloft have saved the lives of millions of people with depression. However, alcohol use becomes significantly more dangerous when taking Zoloft. This can be catastrophic for people battling co-occurring depression and addiction.

Before my alcohol use had become a full-on addiction, I struggled with depression. Eventually, I decided to see a psychiatrist for treatment. She gave me a Zoloft prescription. Before she sent me on my way, she explained that it might take two weeks or longer to work.

Desperate for relief from depression, I was conscientious during those first weeks. I tried to stay physically healthy and get enough sleep, and I didn’t touch alcohol.

It worked! Before long, I felt better than I had in years. Life went on as usual.

But I soon hit a snag. My mood started to dip at the start of every week, before returning to normal.

What had changed? Simple. I’d started drinking on weekends.

What Happens When You Drink Alcohol on Zoloft?

Later, I could recognize that my experience with alcohol had changed. I got drunk quicker and it often felt better than it ever had before. So, at bars or parties, I went straight to the hard stuff.

The dips that came after every weekend gradually got worse than the depression I’d experienced before starting Zoloft. Eventually, I started drinking on weekdays, both to ameliorate the depression and to achieve the sense of ecstasy I’d experienced on the weekend.

Soon, the lows lasted throughout the week and I was drinking daily – with decreasing rewards. I became dependent on alcohol and my lifestyle started to fall apart.

My experience of drinking alcohol while on Zoloft is not an outlier. While the details differ for each person, the combination of alcohol and Zoloft – or other antidepressants – is extremely risky. All-too-often it leads to catastrophic outcomes.

To understand why, a basic knowledge of the mechanisms of both Zoloft and alcohol is necessary.

How Zoloft Works

Zoloft (known generically as sertraline) is an antidepressant in the class of drugs called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the levels of serotonin in the brain, a neurotransmitter associated with mood regulation, anxiety, and overall mental well-being.

Mechanism of Action

Serotonin is a chemical messenger that transmits signals between nerve cells (neurons) in the brain. After serotonin is released into the synaptic gap (the space between two neurons), it binds to receptors on the receiving neuron, transmitting its signal. Normally, any excess serotonin is reabsorbed by the releasing neuron in a process called reuptake.

Zoloft prevents the reuptake of serotonin, effectively increasing the amount of serotonin available. This enhances and prolongs its impact on mood, improving symptoms of depression, anxiety, and other mental health disorders.

How Alcohol Works

Alcohol, on the other hand, is a central nervous system depressant. It is rapidly absorbed into the bloodstream, affecting various neurotransmitters in the brain that impact mood, behavior, and cognitive function.

Mechanism of Action

Alcohol primarily enhances the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that slows down brain activity and produces a calming effect. It also inhibits the activity of glutamate, an excitatory neurotransmitter, further depressing the central nervous system.

Dopamine, a neurotransmitter associated with pleasure and reward, is released at a higher rate, contributing to the euphoric effects of alcohol.

Combining Zoloft and Alcohol

With this in mind, we can begin to understand why the combination of Zoloft and alcohol can be so catastrophic.

Zoloft is used to alleviate depression, whereas alcohol is a depressant. When you drink, your central nervous system is inhibited, creating the opposite effect of the antidepressant. Furthermore, alcohol burns through the dopamine in your brain, causing temporary feelings of euphoria but leaving you with a deficit in the hours or even days that follow.

This explains why I felt so terrible in the days following alcohol use. My mood had been optimal due to the impact of the Zoloft. Suddenly, its impact was being negated and my brain lacked the dopamine to make up for any of it.

Rather than the consistent sense of depression I had experienced before taking antidepressants, my mood would fall off a cliff.

Additional Risks of Using Alcohol with Zoloft

The return of the symptoms of mental illness is not the only risk of using alcohol when on Zoloft. There are other potentially dangerous effects.

Zoloft impacts your cognitive functioning with its influence on serotonin. In isolation, its impact is positive, lifting your mood and reducing anxiety. But when thrown out of balance by alcohol, it can actually impair your cognitive functioning. Alcohol itself impairs cognition, and the combination can lead to a more rapid sense of drunkenness, while negatively influencing decision-making, memory, and coordination.

Alcohol on its own is addictive. Dopamine does not just make you feel good. It is your brain’s way of rewarding you for certain behaviors. By burning through dopamine, alcohol rewards you for its use, reinforcing the behavior.

Zoloft adds another component to the risk of addiction. Because of the lows you feel in the days after drinking, you become more likely to turn to alcohol as a temporary solution. It gradually becomes the way you cope, replacing healthy coping mechanisms.

Finally, long-term use of alcohol in combination with Zoloft can cause damage to your body’s functioning. The liver in particular can be heavily affected.

Going Forward

The risks of using alcohol with Zoloft go far beyond getting excessively drunk or experiencing a hangover the next day. Rather, it can counteract the antidepressant, learning to dangerous dips in mood. This increases the risks of using alcohol more frequently which can lead to addiction.

As such, anyone using Zoloft and other antidepressants should avoid drinking. Even small amounts of alcohol can have a negative impact.

Doctors prescribing Zoloft antidepressants should always inform the patient of the risks of drinking while on it, along with other side-effects that have the potential to cause the person danger.