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SSRIs and Alcohol — MRCPsych Paper B MCQ

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EasyMood DisordersSSRIs and AlcoholMRCPsych Paper B

A woman with major depressive disorder is taking fluoxetine. She has no alcohol dependence and asks whether she can drink alcohol while taking it. Which advice is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — She should avoid alcohol because the combination is not advisable and may increase drowsiness.

Explanation lettering: D = shown as A · A = shown as C · C = shown as D

B is correct. Current UK product information states that combining an SSRI with alcohol is not advisable, and NHS advice recommends avoiding alcohol while taking fluoxetine because it can increase adverse effects such as drowsiness. Alcohol can also impair judgement and may worsen depressive symptoms. It is not, however, listed as a formal contraindication, so A is too absolute. Although formal testing found that fluoxetine did not raise blood alcohol concentrations or enhance alcohol's effects, this does not make unrestricted drinking appropriate, excluding C. Avoidance is not required only when drowsiness has already occurred, so D is unsafe. The advice applies to all alcoholic drinks; wine and beer are not uniquely safe, excluding E.

Reference: Flamingo Pharma (UK) Ltd. Fluoxetine 20 mg Capsules: Summary of Product Characteristics, section 4.5, updated 6 September 2025. https://www.medicines.org.uk/emc/product/13515/smpc