We are frequently asked whether it is safe to drink alcohol while taking ADHD medication.
We asked Dr Sharareh Saboor, Consultant Psychiatrist at BetterCare Mental Health Services, to answer some of the most common questions she receives about alcohol use while taking ADHD medication.
Can I drink alcohol while taking ADHD medication?
Dr Saboor: The safest advice is to avoid alcohol while taking ADHD medication, particularly stimulant medication.
Alcohol may increase adverse effects and can interfere with assessment of treatment response and tolerability.
Advice should be individualised according to the medication prescribed, the dose, physical and mental health, other medications, and the person’s pattern of alcohol or substance use.
Is it safe to drink occasionally?
Dr Saboor: There is no single amount that can be considered safe for every patient taking ADHD medication.
Risk varies according to the medication, dose, individual health factors and pattern of alcohol consumption.
Patients should discuss alcohol use with their prescribing clinician rather than changing or omitting medication themselves in order to drink.
I regularly drink alcohol. Does that matter?
Dr Saboor: Yes. Regular or excessive alcohol use is clinically relevant when assessing and treating ADHD.
It may affect mental and physical health, medication safety, adherence and the clinician’s ability to assess treatment response.
Alcohol and recreational drug use should therefore be discussed openly as part of the assessment and reviewed throughout treatment.
My friends drink while taking ADHD medication and they are fine. Why is your advice different?
Dr Saboor: Individual responses to both alcohol and ADHD medication vary considerably.
The fact that another person has experienced no apparent adverse effects does not establish that the combination is safe.
Clinical recommendations are based on the individual patient’s circumstances, current prescribing information and established clinical guidance rather than the experiences of friends or cultural or social drinking practices.
How do ADHD medications interact with alcohol?
Dr Saboor: The interaction depends on the particular ADHD medication.
Alcohol may increase or alter adverse effects and can complicate assessment of treatment response.
Product-specific prescribing information should be followed, and patients should discuss alcohol use with their prescriber.
Can ADHD medication change how drunk you feel?
Dr Saboor: Potentially. Stimulants and alcohol have different effects on the central nervous system, and subjective alertness should not be used as an indication of the degree of alcohol-related impairment.
A person may still have impaired judgement, coordination and reaction time even if they do not feel particularly sedated.
Can alcohol interfere with ADHD medication?
Dr Saboor: Yes. Alcohol can independently affect concentration, judgement, mood, sleep and behaviour and may also increase medication-related adverse effects.
This can make it more difficult to determine whether symptoms or side effects are related to ADHD, the medication, alcohol, or a combination of these factors, particularly during medication titration.
Are people with ADHD more likely to misuse alcohol or drugs?
Dr Saboor: ADHD is associated with an increased risk of substance misuse and self-medication, but this does not mean that every person with ADHD will develop alcohol or substance-use problems.
For this reason, alcohol and recreational drug use should form part of a comprehensive ADHD assessment and ongoing clinical review.
When should alcohol or recreational drug use be discussed with the clinician?
Dr Saboor: From the initial ADHD assessment and before medication is prescribed.
Alcohol and recreational drug use should form part of the clinical assessment when considering the safety and appropriateness of ADHD medication.
Patients should also inform their clinician during treatment if they start using alcohol or recreational drugs, if their pattern of use changes or increases, or if substance use is affecting their medication, mental health or daily functioning.
What practical steps can people take to reduce risk?
Dr Saboor: Patients should follow the instructions for their particular medication and discuss alcohol or recreational drug use openly with their prescriber.
They should not skip, delay, increase, reduce or otherwise alter their ADHD medication in order to accommodate alcohol or recreational drug use without advice from their prescribing clinician.
Where regular, heavy or problematic alcohol or drug use is identified, this requires an individual clinical assessment and review of the safety and appropriateness of ADHD treatment.
When should someone seek urgent medical attention?
Dr Saboor: Urgent medical assessment is required following alcohol, medication or recreational drug use if a person develops:
- loss of consciousness
- a seizure
- severe confusion
- significant breathing difficulty
- chest pain
- collapse or fainting
- a severe or persistent abnormal heart rate
The HSE Drugs and Alcohol Helpline provides free and confidential information and support to people who are concerned about their own or someone else’s alcohol or drug use.
If you would like support with ADHD assessment, medication or ongoing treatment, BetterCare’s psychiatry and ADHD teams can help. You can also book a free consultation if you are not sure which service is right for you.
This information is general in nature and does not replace an individual clinical assessment or the prescribing information for a specific medication. Speak to your doctor, psychiatrist or pharmacist about your particular medication.
