Epilepsy & Alcohol

A common question people with epilepsy have is how alcohol use may affect their seizures. Doctors, nurses and pharmacists often warn against the use of alcohol in people with epilepsy. While drinking can have serious consequences for people with epilepsy, it may not be realistic to completely avoid alcohol. With this in mind, what do people with epilepsy need to know in order to safely and responsibly make decisions about their use of alcohol and other substances?

Limited amounts of alcohol neither change the amount of anti-epileptic medication in your bloodstream nor cause seizures. However, anti-epileptic medications are known to lower alcohol tolerance, meaning you may get intoxicated quicker. This is a problem because many side effects of these medications are similar to the effects of alcohol itself. This combination might be even worse for you if you are already sensitive to anti-epileptic medications or alcohol.

Speak with your doctor or pharmacist about how your medication interacts with alcohol as some medications have an absolute zero tolerance for alcohol, causing serious side effects, while other medications may have a higher tolerance. This tolerance can also differ from person to person, depending on such things as nutrition, body mass and overall health. Based on these things, your doctor can give recommendations on how much, if any, alcohol you can drink.

It is important to remember that consistent drinking, such as a glass of wine every evening, can affect the performance of anti-epileptic medications and cause problems for your healthcare team in trying to identify the right medication for you. This may lead to your dosages and medications being switched unnecessarily.

Seizures that are associated with alcohol are usually a result of withdrawal, not of the drinking itself. However, your risk of a seizure could increase greatly after three or more drinks. Binge drinking and withdrawal may also cause status epilepticus, a serious and dangerous condition in which seizures will not stop on their own. Therefore it is very important to avoid binge-drinking, or drinking too much over a short period of time. If you plan to drink socially, drink a lot of water and eat while drinking to avoid becoming intoxicated.

Seizures caused by alcohol withdrawal are most common among people who have abused alcohol for years. Suddenly stopping or significantly reducing intake of alcohol over a short time may cause a seizure. People with and without epilepsy may experience this. In fact, long-term alcohol abuse can lower a person’s seizure threshold and therefore increase a person’s risk of developing epilepsy.

Responsible substance use requires a lot of consideration, but there are extra concerns for those living with epilepsy. If you have any questions, please contact your neurologist or pharmacist.