Is It Safe to Drink Alcohol With an Anxiety Disorder?
Key takeaways
Alcohol may worsen anxiety symptoms, especially after it wears off. It also commonly co‑occurs with anxiety disorders.
“Moderate” drinking means two drinks or less in a day for men and one or less for women; more than that increases risk. A “standard drink” equals 14 g (0.6 fl oz) of pure alcohol.
Mixing alcohol with anxiety medications—especially benzodiazepines—can be dangerous. Avoid this combination.
Some people should not drink at all, including those who are pregnant, under 21, have alcohol use disorder, or are taking certain medicines.
Table of Contents
Why alcohol can worsen anxiety
Alcohol can feel calming at first. It increases activity in brain reward pathways and shifts the balance of key neurotransmitters. But these changes are temporary and can rebound.
What happens in your brain
During drinking, alcohol enhances GABA (a calming neurotransmitter) and suppresses glutamate (an excitatory one). With repeated or heavy use, the brain adapts. After alcohol wears off, the balance can swing the other way, which can heighten anxiety and restlessness.
“Hangxiety” after drinking
Many people notice anxiety the day after drinking—often called hangxiety. This reflects both the neurochemical rebound described above and common hangover factors (poor sleep, dehydration, and physical discomfort). For people prone to anxiety, these effects can feel stronger.
Long‑term patterns and anxiety risk
Alcohol and anxiety frequently co‑occur. People may drink to blunt anxious feelings, but the relief is short‑lived and can lead to heavier use over time. This pattern can worsen anxiety and increase the risk of alcohol use disorder (AUD).
Research on low‑volume drinking and long‑term anxiety is mixed and still evolving, but the clear consensus is that heavy or binge drinking raises health risks, including for mental health. Binge drinking is typically 4+ drinks for women or 5+ for men on one occasion; heavy drinking is 8+ per week for women or 15+ for men.
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Alcohol and anxiety medications
Antidepressants (SSRIs/SNRIs and others)
If you take antidepressants for an anxiety disorder, combining them with alcohol can worsen side effects like drowsiness and poor coordination and can aggravate anxiety or low mood. It’s best to avoid drinking on Prozac (fluoxetine) or other medicines unless your clinician says otherwise.
MAOIs interact with certain foods and beverages; beer and red wine, for example, can pose special risks due to tyramine content. Always follow your prescriber’s guidance.
Benzodiazepines and other sedatives
For drugs such as alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), or diazepam (Valium)—do not drink alcohol. The FDA warns that combining benzodiazepines with alcohol can cause profound sedation, respiratory depression, coma, or death. The safest course is to avoid alcohol entirely while using these medicines.
Other medications sometimes used in anxiety care (e.g., certain sleep aids or off‑label sedatives) can interact with alcohol, too. Ask your prescriber or pharmacist about your specific regimen.
Who should avoid alcohol
You should not drink alcohol if you:
Are pregnant or under 21.
Have alcohol use disorder or are in recovery.
Plan to drive or operate machinery.
Take medications that interact with alcohol (especially benzodiazepines, opioids, some sleep medicines, and certain antidepressants).
Have a condition made worse by alcohol (including some anxiety presentations where rebound symptoms are severe).
If you choose to drink: safer‑use tips
If you and your clinician decide drinking is acceptable for you, keep these guardrails in mind:
- Know a standard drink: 12 oz of 5% beer, 5 oz of 12% wine, or 1.5 oz of 40% spirits each equal one standard drink. Serving sizes in restaurants and mixed drinks may contain more than one.
- Stay within moderate limits: up to 1 drink/day for women and 2 for men (not an average to “save up” for weekends). Even within these limits, some people experience anxiety flare‑ups.
- Avoid binge patterns: 4+ (women) or 5+ (men) drinks on one occasion qualifies as binge drinking and raises risk.
- Protect sleep: alcohol disrupts sleep quality; poor sleep often worsens anxiety.
- Don’t mix with anxiety meds or other sedatives: when in doubt, skip alcohol and ask your clinician.
- Try alternatives: alcohol‑free beers and mocktails, or non‑alcohol options, can help at social events.
Practical supports for anxiety without alcohol
Evidence‑based options include cognitive behavioral therapy (CBT), other psychotherapies, exercise, structured sleep routines, and clinician‑guided medication when needed. If alcohol use has become hard to control, confidential help is available 24/7 via the 988 Suicide & Crisis Lifeline (call or text 988) and the SAMHSA resources, including FindTreatment.gov.
Bottom line
Alcohol might feel like short‑term relief, but it often leads to more anxiety later and can interact dangerously with anxiety medications, especially benzodiazepines. For many people with an anxiety disorder, the safest and most effective plan is to limit or avoid alcohol and use proven anxiety treatments instead. If you do drink, stay within moderate limits and keep your prescriber in the loop.
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FAQ: Prescription Drugs — Definitions, Meaning & Safe Use
What is a “standard drink”?
In the U.S., one standard drink has 0.6 fl oz (14 g) of pure alcohol—about 12 oz beer (5% ABV), 5 oz wine (12% ABV), or 1.5 oz 80‑proof spirits. Serving sizes may contain more than one standard drink.
What counts as “moderate” drinking?
Public‑health guidance commonly frames moderation as up to 1 drink/day for women and up to 2/day for men (not averaged to “save up”). Lower is safer.
How many drinks is binge drinking?
Binge drinking typically means reaching 0.08% BAC—about 4+ drinks for women or 5+ for men in ~2 hours.
Does alcohol worsen anxiety?
Often, yes. Alcohol initially dampens brain activity but later rebounds, which can increase anxiety and disturb sleep; chronic use is linked with anxiety and sleep problems.
Why do I feel anxious the day after drinking (“hangxiety”)?
Post‑drinking anxiety can stem from neurochemical rebound, poor sleep, dehydration, and mood effects. Many people report this next‑day anxious state.
Is moderate drinking safe if I have an anxiety disorder?
Some people with anxiety find even small amounts worsen symptoms or sleep. Discuss your history and medications with your clinician; less is safer.
Can quitting or cutting back on alcohol reduce anxiety?
For many, yes—less alcohol can mean fewer rebound symptoms and better sleep. Persistent anxiety should be evaluated and treated on its own as well.
What are signs of alcohol misuse or addiction?
Warning signs include inability to cut down, cravings, continued use despite harm, and withdrawal—hallmarks of alcohol use disorder (AUD).
Is AUD the same as “alcoholism”?
AUD is the clinical term that includes what people often call alcoholism; it ranges from mild to severe based on symptoms.
What happens to your body when you binge drink?
Binge drinking raises short‑term risks (injuries, alcohol poisoning) and long‑term risks (hypertension, liver disease). More drinking means more risk.
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Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for consultation with a licensed physician, psychiatrist, or other qualified health professional who can evaluate your specific circumstances. Do not start, stop, or change any medication—or consume alcohol while taking medication—without guidance from your prescriber or pharmacist, as interactions can be dangerous. If you drink heavily or have a history of withdrawal, do not attempt to detox without medical supervision. If you are experiencing a medical or mental‑health emergency, call 911 immediately; for confidential support in the U.S., call or text 988 (Suicide & Crisis Lifeline). Information here reflects general guidance at the time of publication and may not remain current or apply to every individual. Reading this content does not create a clinician–patient relationship with Nova Recovery Center, and nothing herein constitutes endorsement or encouragement of alcohol use.
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