If you have epilepsy you may have heard about risks related to alcohol and seizures. It is true that drinking beer, wine and spirits may make you more likely to have a seizure. So, it’s important to be aware of the facts around epilepsy and alcohol. 

Here are some of the key factors it’s important to be aware of:

• Effects of withdrawal

Heavy drinking can affect people’s seizure threshold. When they stop drinking, it can then make their brains more ‘excitable’, and this can lead to seizures. 

• Sleep deprivation

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

Learn more: Epilepsy seizure triggers

• Interaction with anti-epilepsy drugs

Alcohol and seizure medication may interact in ways that make it more likely that some people will have a seizure. For example, alcohol may reduce the levels of some anti-seizure medication (ASM) in your blood or alter their effectiveness in the brain. This may make seizures more likely. Speak to your doctor and read the leaflet in the packet for more information. Combining ASMs with alcohol may also increase the side effects of medications, such as dizziness or drowsiness, and may also increase your risk of liver problems. 

• Whether or not seizures are controlled

There is evidence that people who have uncontrolled seizures are more likely to have seizures after drinking (but people with controlled seizures could also be at risk). 

• Seizures caused by alcohol

Withdrawing (stopping drinking) from alcohol causes people’s  brains to become more excitable. This means that some people who do not actually have epilepsy may also experience seizures when they stop drinking. This is especially true for alcoholics or people who often drink heavily.

To learn more about the risks of epilepsy and alcohol, speak to your medical team. 

Epilepsy and alcohol - is it ever safe?

Alcohol can be a big part of many people’s social life, so you may be wondering if it’s ever safe. Remember that even a small amount of alcohol is bad for your health, and it is lower risk to avoid alcohol altogether, according to the CDC.

First, talk with your doctor about the risks, and read the leaflet inside your anti-epilepsy medication. . 

An analysis of studies into alcohol and epilepsy reported that having one or two drinks  does not appear to significantly increase the risk of seizure activity. ‘One drink’ means:

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

Of course, it is lower risk - and better for your general health - to avoid alcohol altogether. If you have epilepsy and would like to drink alcohol, it’s best to speak with your physician about this first.

Avoid binge drinking

Perhaps 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. Avoid binge drinking if you have epilepsy. 

Can alcoholism cause seizures?

Possibly. Studies have found that an unusually high number of alcoholics also have epilepsy.

The most direct way alcoholism causes seizures is during withdrawal, which is when someone with alcohol dependence 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. It’s important to be aware that uncontrolled alcohol withdrawal can be fatal, and there is a risk of Sudden Unexpected Death in Epilepsy.  

That being said, there is evidence that alcoholism could cause long term epilepsy too. One theory is 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?

If you take an ASM, speak with your doctor about the risks of drinking alcohol. They can advise you on what is safe for you and if there could be interactions. You should also read the leaflet of your ASM. 

It’s important to be aware of certain risks:

• 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. 

• Drinking alcohol with your seizure medicine can make both drugs’ effects stronger. Many ASM’s 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, benzodiazepines, which are found in certain epilepsy medications, including clonazepam, lorazepam, and diazepam. When this drug interacts with alcohol, it can affect your heart rate and breathing, and could be very dangerous. This is why it’s essential to read the leaflet in your ASM packaging. 

Speak with your doctor

Drinking alcohol poses real risks to everyone’s health, and it can be especially risky if you have epilepsy. Talk with your doctor about epilepsy and alcohol for advice about what’s best for you.