Paroxetine (Paxil) is an antidepressant. It’s used to treat many conditions, including:

Paxil is a selective serotonin reuptake inhibitor (SSRI). It helps increase the levels of serotoninin, a chemical messenger that affects your mood. Mixing alcohol with Paxil can lead to some unwanted side effects. Paxil may also affect alcohol cravings, though findings on this influence are still unclear.

Read more: What to know about SSRIs »

Increased symptoms

Alcohol can make the symptoms of depression worse. It may also make Paxil less effective at treating depression. If the drug doesn’t work as well, your symptoms may come back. Because of these factors, people should avoid drinking alcohol while they take Paxil.

Increased side effects

Alcohol also can increase some of Paxil’s side effects, especially dizziness, sleepiness, and trouble concentrating. Other side effects of Paxil that alcohol can increase include:

  • agitation
  • changes in vision
  • hallucinations (seeing or hearing things that aren’t real)
  • high or low blood pressure
  • decreased sex drive
  • mood swings
  • irregular heart rhythm
  • joint pain
  • loss of emotional feeling
  • nausea
  • vomiting
  • diarrhea
  • paranoia
  • mania (racing thoughts or excess energy)
  • rigid muscles, poor muscle control, or uncontrolled muscle movements
  • suicidal thoughts or actions
  • unintentional weight gain

The relationship between Paxil and alcohol misuse is unclear. Some information seems to indicate that Paxil use helps curb the reliance on alcohol in people with anxiety disorders, while other information has indicated just the opposite.

A study in the journal Alcoholism: Clinical & Experimental Research investigated the relationship between social anxiety and alcohol use disorders. For people with social anxiety disorders who misused alcohol to make them feel more comfortable in social settings, the results suggest taking Paxil allowed them to engage more easily without drinking alcohol. In other words, Paxil reduced their need for alcohol to ease discomfort in social situations. This effect may have reduced alcohol dependence and misuse in these people.

On the other hand, some research has linked the use of SSRIs like Paxil to increased alcohol cravings and misuse. In a review of studies on SSRIs and alcohol dependence, researchers found that SSRIs actually led to an increase in alcohol consumption in some groups. This risk might be higher in people who have certain genes that already make them more prone to alcohol misuse.

Paxil can also interact with a number of drugs. While you’re taking Paxil, you should avoid taking MAO inhibitors and the antipsychotic thioridazine (Mellaril). You should also avoid the antipsychotic drug pimozide (Orap). All of these drugs can cause severe side effects when you take them with Paxil.

Other drugs that can cause problems if you take them with Paxil include:

  • cimetadine (Tagamet), used to treat gastroesophageal reflux disease (GERD)
  • fentanyl, an opioid pain reliever
  • drugs that thin the blood such as warfarin, rivaroxaban, and apixaban
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
  • epilepsy medications
  • drugs used to treat irregular heartbeats, schizophrenia, and HIV infection
  • metoprolol (Lopressor, Toprol XL), a blood pressure lowering drug
  • other antidepressants such as tricyclics, lithium, SNRIs, or SSRIs
  • procyclidine (Kemadrin), a drug used to treat Parkinson’s disease
  • tamoxifen, a breast cancer drug
  • triptans, used to treat migraine headaches

You should let your doctor know about all drugs you take, including over-the-counter drugs as well as herbal remedies, vitamins, and supplements.

If your doctor has prescribed Paxil or another antidepressant, ask about all the possible side effects and interactions it can cause. Be careful about using alcohol or drugs that might interact with your antidepressant.

If you think that Paxil is increasing your alcohol use, talk about it with your doctor. They may be able to recommend a drug that is better suited for you.