Most people who have epilepsy can safely consume light to moderate amounts of alcohol (up to two drinks per day) without increasing the risk of seizure activity. However, heavy or chronic alcohol use by people with epilepsy is associated with some risk — particularly if binge drinking is involved.
People without epilepsy who struggle with severe alcohol use disorder (AUD) may experience non-epileptic seizures during withdrawal. Evidence suggests that people with chronic AUD who have gone through multiple withdrawal episodes with seizures are at risk for developing epilepsy.
Is it Safe to Drink Alcohol if Diagnosed With Epilepsy?
People with epilepsy can safely consume moderate amounts of alcohol. The Epilepsy Foundation identifies a moderate amount as a maximum of two drinks and recommends that they are consumed slowly. People with epilepsy who take anti-epileptic drugs or other prescription medications should understand how alcohol interacts with their medications. It is recommended that anyone with epilepsy discuss alcohol use with their doctor.
Although people with epilepsy can generally consume alcohol in moderation, exceeding moderate amounts can be dangerous. The following are some tips for individuals concerned about their alcohol use:
- Avoid binge drinking: A 2018 study evaluated 204 people with epilepsy to clarify the link between alcohol use and epileptic seizure activity. Of the people who reported alcohol-related seizures, all of them consumed large amounts of alcohol within the 24 hour period preceding their seizure. None of the people who used alcohol in moderation reported alcohol-related seizures.
- Avoid alcohol misuse: Chronic alcohol misuse is a risk factor for seizures. People with epilepsy who develop alcohol dependence or addiction have a reduced seizure threshold and their AEDs may be less effective.
- Moderation is key: While moderation is urged for everyone, it is especially important for people with epilepsy. Seizure risk is increased with excessive or chronic alcohol use.
Alcohol and Epilepsy Medicine
Combining moderate amounts of alcohol and epilepsy medication can be done safely, but there are risks. Alcohol can interact negatively with many anti-epileptic drugs (AEDs) and several AEDs reduce alcohol tolerance. In addition, alcohol can reduce the efficacy of AEDs.
Most AEDs are central nervous system (CNS) depressants, meaning that they reduce activity in the brain. Alcohol is also a CNS depressant, and combining alcohol and AEDs can cause brain activity to drop so low that coma or death are possible. If you are prescribed an AED, make sure you talk with your doctor about the risks of alcohol use.
Epilepsy and Alcohol Withdrawal
The Epilepsy Foundation defines epilepsy as, “…a chronic disorder, the hallmark of which is recurrent, unprovoked seizures.” Alcohol-induced seizures are provoked, so they do not strictly fit the definition of epilepsy. People with chronic AUD who have had multiple alcohol withdrawal-related seizures are at higher risk for developing epilepsy. However, whether idiopathic (spontaneously arising) epilepsy and alcohol-induced epilepsy are the same disorder remains unclear. Interestingly, epileptic seizures have been shown to have very different effects on brain activitycompared to the effects of alcohol-related seizures.
Severe alcohol withdrawal is associated with rapid and profound changes in brain chemistry. Chronic, heavy alcohol abuse causes a persistent reduction in brain activity and, if alcohol intake is stopped suddenly, the “brake” that was keeping the brain at a slow pace is removed. Consequently, brain activity accelerates to the point of hyperexcitability. This underlies the symptoms of alcohol withdrawal, including anxiety, tremors, sweating and hyperthermia and, if severe enough, can trigger seizures. If someone undergoes withdrawal several times with seizure activity, they may have an increased risk for developing epilepsy.
Key Points: Alcohol and Epilepsy
Keep the following key points in mind when considering alcohol and epilepsy:
- Light to moderate amounts of alcohol (no more than two drinks per day) are generally safe for people with epilepsy
- Binge drinking is associated with increased seizure activity
- Chronic alcohol use may increase the frequency of seizure activity
- Alcohol can reduce the efficacy of anti-epileptic drugs
- Anti-epileptic drugs can reduce alcohol tolerance
- Alcohol use can cause seizure activity, but alcohol-related seizures and epilepsy are not the same
- People with severe alcohol use disorder who have experienced multiple alcohol-related seizures may become predisposed to developing epilepsy, but it is unknown if alcohol-induced epilepsy and idiopathic epilepsy should be considered the same disorder
If you or someone you love is struggling with alcohol use disorder, call the Orlando Recovery Center to speak with a representative about how professional addiction treatment can help get you on the path to recovery.
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The Epilepsy Foundation. “Alcohol.” March 2014. Accessed August 18, 2019.
Hamerle, Michael; Ghaeni, Leyli; Kowski, Alexander; Weissinger, Florian; Holtkamp, Martin. “Alcohol Use and Alcohol-Related Seizures[…]ients With Epilepsy.” Frontiers in Neurology, June 2018. Accessed August 18, 2019.
Hillbom, Matti; Pieninkeroinen, Ilkk; Leone, Maurizio. “Seizures in alcohol-dependent patients: […]logy and management.” CNS Drugs, January 2013. Accessed August 18, 2019.
Drugs.com. “Seizure/Epilepsy Medications and Alcohol.” November 2017. Accessed August 18, 2019.
Leach, John Paul; Mohanraj; Rajiv Borland, William. “Alcohol and drugs in epilepsy: Pathophys[…]ties, and prevention.” Epilepsia, September 2012. Accessed August 18, 2019.
The Epilepsy Foundation. “What is Epilepsy?” January 2014. Accessed August 18, 2019.
Bråthen, Geir; et al. “Alcohol-related seizures.” European Handbook of Neurological Management, 2011. Accessed August 18, 2019.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.