Mixing Lexapro and Cocaine – What Are the Risks?

Many people who have been prescribed Lexapro (escitalopram) by their doctor hope that it will improve their quality of life. However, it is important to note that new medications often require big changes to our life choices. Mixing Lexapro and cocaine can have very serious, even deadly, outcomes, so keep reading to learn more about how to keep yourself safe.

Is Mixing Lexapro and Cocaine Dangerous?

Yes, mixing Lexapro and cocaine can be dangerous. This is mainly because of the potential pharmacological interactions that occur when taking more than one ‘substance’ or ‘drug’ at once.

Taking more than one substance at once is also referred to as ‘poly-substance use’. The most dangerous kinds of poly-substance use involve mixing different ‘classes’ of drugs such as stimulants and depressants, or hallucinogens and cannabinoids. Some examples of common, even accepted poly-substance use include:

  • Redbull and Vodka (stimulant and depressant)
  • Alcohol and Nicotine (depressant and stimulant)
  • Coffee and a smoke (two stimulants)
  • Alcohol and party drugs like cocaine or MDMA (depressant and stimulant)

Most people who are prescribed Lexapro and other SSRIs are recommended to avoid the intake of any substances such as alcohol, marijuana, and other illicit drugs. This is not only because the effects of recreational drug use may counteract the efficacy of the SSRIs, but also because there can be unpredictable pharmacological interactions. When discussing Lexapro and cocaine specifically some examples of such side effects include:

  • Increased heart rate and blood pressure
  • Serotonin Syndrome, which we discuss in more detail further below
  • Emotional instability, such as nervousness, anxiety, and agitation
  • Gastrointestinal disturbances such as nausea, vomiting, or diarrhea
  • Insomnia
  • Restlessness
  • Any other potential side effects that may be caused within the context of your unique biology

Poly-substance use always carries a risk of the unknown and unpredictable. To ensure your safety and wellbeing, you should avoid the simultaneous use of any drugs, whether legal or illegal, prescribed or unprescribed.

What Are the Effects of Lexapro and Coke?

Lexapro, otherwise known as escitalopram, is a Selective Serotonin Reuptake Inhibitor (SSRI). It is often prescribed for concerns such as depression and anxiety. It works by blocking the reabsorption of serotonin in the brain, which ultimately increases the levels of serotonin available between nerve cells.

Cocaine, commonly known as coke, is a powerful, illegal, and highly addictive stimulant drug. It works by blocking the reabsorption of, primarily, dopamine, which increases the amount of dopamine available between the nerve cells.

You may be familiar with serotonin and dopamine as ‘feel good’ neurotransmitters in the brain, and therefore may be under the impression that two good things must be extra good. However, there are key differences in why the effects of Lexapro are more ideal than those of cocaine:

  • SSRIs are evidence proven to support the long-term improvement of mental health and wellbeing, whereas long-term use of cocaine is demonstrated to have severely negative physical and psychological impacts on the user
  • While both drugs increase neurotransmitter levels, Lexapro does this gradually over time, contributing to improved mood and emotional stability. Cocaine does this extremely quickly, leading to feelings of intense euphoria before the come down or ‘crash’
  • This difference in speed of action means that SSRIs can provide long-term relief from symptoms when taken consistently, whereas cocaine’s short-lived effects often lead to a cycle of repeated use in order to maintain the pleasurable experience
  • SSRIs are considered safe when used as prescribed under medical supervision. Cocaine use is never considered ‘safe’, when taking into account risk of addiction, purity of substance, serious health risks, risky behaviour under the influence, and the potential for fatal overdoses

Can Mixing Cocaine and Lexapro Cause Serotonin Syndrome?

Yes, mixing cocaine and Lexapro can increase your risk of developing Serotonin Syndrome. Serotonin Syndrome is a potentially life-threatening condition that occurs when there is an excessive accumulation of serotonin in the brain and body. This most typically happens when people mix substances that both have impacts on neurotransmitters in the brain, specifically serotonin.

Symptoms can include:

  • Agitation or restlessness
  • Confusion
  • Rapid heart rate and high blood pressure
  • Dilated pupils
  • Sweating
  • Shivering
  • Tremors or muscle twitching
  • Muscle rigidity
  • Nausea, vomiting, or diarrhea
  • Headache
  • In severe cases, seizures, high fever, irregular heartbeat, and unconsciousness

When mixing SSRI medications and stimulants, you are using two substances that can impact levels of serotonin in the brain. Therefore mixing Lexapro with cocaine, and also with other stimulant drugs like MDMA, amphetamines, and Adderall, can put you at severe risk.

It is important to note that serotonin syndrome is a serious and potentially life-threatening condition. If you suspect that you, or someone you know, may be suffering from it, please seek medical attention urgently.


If your doctor has prescribed you Lexapro, it is likely because you are experiencing depression or anxiety and have sought out help. We want to congratulate you on taking this first step towards wellness.

It is important to prioritise your wellbeing, and one way of doing so is by ultimately abstaining from poly-substance use. Please remember that mixing Lexapro and cocaine, or any other drug, can be dangerous, or even fatal.

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