Epilepsy and alcohol - can you drink safely?

  • October 30, 2020
  • 3
In this article

Epilepsy and alcohol have often been seen as a dangerous mix and people who have seizures may be warned to avoid drinking. However if you are an adult, you should be able to make an informed decision about what’s right for you. 

So, let's look at the facts about alcohol and seizures.

What is the risk of mixing epilepsy and alcohol?

If you have epilepsy you may have heard about the link between alcohol and seizures. It is true that drinking beer, wine and spirits can make you more likely to have a seizure. Here are the risk factors that you should be aware of:

  • Effects of the hangover

When you are hungover, your brain is dehydrated. This is a common factor in seizures caused by alcohol. Many people with epilepsy have their first seizure when they are hungover.

  • Sleep deprivation

Alcohol can also interact with your body's sleep pattern. For many people with epilepsy, poor sleep can be a seizure trigger.

Learn more: Epilepsy seizure triggers

  • Interaction with anti-epilepsy drugs

Alcohol and seizure medication can sometimes interact in ways that make it more likely that you will have a seizure or affect your health in other ways. For example, Keppra and alcohol may increase your risk of liver problems. Meanwhile lamotrigine and alcohol may cause you to feel very sleepy. Anti-epilepsy drugs can also reduce your tolerance to alcohol which means you will feel drunker faster.

  • Whether or not seizures are controlled

People whose seizures are controlled by drugs or a medical device may have fewer problems drinking alcohol. On the other hand, if your seizures are not controlled, drinking alcohol is more risky.

  • Seizures caused by alcohol

Alcohol can cause your brain to become more excitable. This means that some people who do not actually have epilepsy may also experience seizures when drinking. This is especially true for people who often drink heavily.

If you have any doubts about epilepsy and alcohol, speak to your medical team for more advice. It is also worthwhile to speak with your pharmacist to find out whether you can drink alcohol with your anti-epilepsy drugs. 

Epilepsy and alcohol - is it ever safe?

While it is important to be aware of the risks, research shows that most people with epilepsy can drink a small amount of alcohol without any serious danger. You will of course want to check with your doctor and read the leaflet inside your anti-epilepsy medication, but an occasional beer, glass or wine or spirit is normally fine.

Studies have shown that one or two drinks a day does not increase the risk of seizure activity. One drink means:

  • A small glass of wine
  • A can of beer
  • One shot of distilled spirits

Avoid binge drinking

The biggest risk with alcohol and seizures is binge drinking. This is when you drink a lot of alcohol in a short amount of time or drink continually for many hours.

Sometimes it can be hard to avoid drinking in certain social situations - such as at college parties or festivals. If you are going somewhere where you think people will be drinking heavily, you might want to bring your own non-alcoholic drinks so you can still take apart without risking having a seizure.

Can alcoholism cause seizures?

Yes, there is a lot of evidence that alcoholism (being addicted to alcohol) can cause seizures. 

The most direct way alcoholism can cause seizures is during withdrawal, which is when an alcoholic stops drinking. Alcohol affects your brain in complex ways. To simplify, alcohol relaxes your brain, which makes seizures less likely. But when people who drink a lot suddenly stop, their brain suddenly becomes much more active. That can trigger a seizure - usually within 6-48 hours after stopping drinking. Some people seem to be more prone to having seizures during alcohol withdrawal. It doesn’t necessarily mean they will go on to develop epilepsy, which is where you have two or more unprovoked seizures. 

That being said, there is evidence that alcoholism could cause long term epilepsy too. Studies have shown that when someone repeatedly binges on alcohol and then withdraws, it gradually causes permanent changes in the brain. These changes mean that the person would be more likely to have seizures in future, even if they stopped drinking alcohol altogether.  

Can you drink alcohol while taking seizure medication?

The short answer is that it depends. For many people who take seizure medication, an occasional drink is relatively low risk, and is unlikely to cause breakthrough seizures. There are still issues to be aware of:

  • Alcohol can make some seizure medications less effective. It can make your body process certain anti-seizure medication faster, which could lead to a breakthrough seizure. Check the patient leaflet that comes with your epilepsy medication to learn about possible interactions. 
  • Drinking alcohol with your seizure drugs can make both drugs’ effects stronger. Many seizure drugs have a sedative effect (makes you drowsy), as does alcohol. Therefore, a couple of alcoholic drinks consumed alongside your seizure meds could make you feel ‘drunk’ much faster than other people. 

Some anti-epilepsy drugs should never be mixed with alcohol. In particular, benzodiazepine is found in certain epilepsy medications, including clonazepam (Klonopin), lorazepam, and diazepam (Valium). When this drug interacts with alcohol, it can affect your heart rate and breathing, and could be very dangerous.

Adult choices

In the end you are an adult and you can make the best choices for yourself. For many people with epilepsy it is perfectly fine to drink small quantities of alcohol from time to time without having a higher risk than usual of seizures. By making sensible choices about epilepsy and alcohol, you could possibly enjoy a drink without worrying about the consequences. 

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