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Interactions between recreational drugs and psychiatric medication

Find out how certain mental health medications and recreational drugs can interact with each other, and how this might affect your body.

If you take two or more types of drug around the same time, this can sometimes affect how the drugs work. This is known as an interaction.

Some types of recreational drugs and alcohol can interact with prescribed medication. This includes interactions with certain psychiatric medications.

Below is a list of some reported interactions between psychiatric medications and recreational drugs. There may be other interactions that we haven't listed here.

  • MAOI antidepressants with many drugs – can cause very dangerous effects, including very high blood pressure, chest pain, neck stiffness, rigid muscles, flushing, vomiting and severe headaches.
  • 'Reversible' MAOI antidepressants, such as moclobemide, with stimulants – may cause dangerous effects similar to those caused by MAOI antidepressant interactions.
  • Antipsychotics with amphetamine – may reduce the effects of both drugs.
  • Lithium with alcohol or ecstasy – dehydration (low levels of water in your body) may cause lithium levels to become toxic.
  • Carbamazepine with methadone – reduces your methadone levels.
  • Ketamine with depressants, such as alcohol – reduces your breathing.
  • Most antidepressants, antipsychotics and tranquillisers with alcohol – may increase the medication's sedative effects, slowing down the body and brain's functions. They might also increase your loss of co-ordination or control over fine movement.
  • First generation antipsychotics with ecstasy – may increase the risk of movement disorders.
  • Citalopram with cocaine – may cause high blood pressure and increase your risk of bleeding, including on the brain. This may also happen with cocaine and other SSRI antidepressants.
  • Risperidone with cocaine – may reduce 'high' of cocaine.
  • Clozapine or olanzapine with cannabis – reduces your levels of clozapine or olanzapine.
  • Clozapine or olanzapine with smoked tobacco – reduces your levels of clozapine and olanzapine. Your dose may need to be adjusted if you stop or start smoking while taking these medications.​

This information was published in June 2022. We will revise it in 2025.

References and bibliography available on request.

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