Alcohol as a Seizure Trigger

May 4, 2022

Alcohol as a Seizure Trigger

Epilepsy Foundation
Authored By: Steven C. Schachter, MD
Reviewed By: Joseph I. Sirven MD
April 27, 2022

Doctors and pharmacists are always warning people with epilepsy about alcohol. If you have epilepsy, drinking alcohol can have serious consequences. Most people with epilepsy are told to not drink, but that’s not always realistic. Others are told to drink moderately.

So what should people with seizures and epilepsy be aware of?

Alcohol and Seizures: Some Facts

In small amounts, alcohol does not cause seizures. A drink or two now and then does not increase seizure activity.
Small amounts of alcohol don’t change the amount of seizure medicines in your blood or change findings on EEG (electroencephalogram) studies.
When alcohol is related to seizures, it is often the state of alcohol withdrawal that causes the seizures, not the drinking itself. Your risk of seizures may be much higher after having three or more alcoholic beverages.
Binge drinking and alcohol withdrawal can even lead to status epilepticus, a life-threatening and potentially fatal problem!
Seizure medicines can lower your tolerance for alcohol, so the immediate effects of alcohol consumption are greater. In other words, people get drunk faster. Rapid intoxication is a big problem because many of the side effects of these medicines are similar to the acute effects of alcohol itself. If you are sensitive to alcohol or seizure medicines, you may find the combination even worse.
Some studies have shown that alcoholism, or chronic abuse of alcohol, is linked with the development of epilepsy in some people. This research suggests that repeated alcohol withdrawal seizures may make the brain more excitable. Thus, people who have experienced seizures provoked by binge drinking may begin to experience unprovoked epilepsy seizures regardless of alcohol use.

How should I manage alcohol if I have seizures or epilepsy?

Avoid binge drinking.

Binge drinking is drinking too much at once or over long periods of time.
Alcohol usually does not trigger seizures while the person is drinking.
“Withdrawal” seizures may occur 6 to 72 hours later, after drinking has stopped.

Don’t abuse alcohol.

If you have a problem with it, get help.
Alcohol withdrawal seizures may be different than epilepsy seizures or make epilepsy worse.
Withdrawal seizures are most common among people who have abused alcohol for years.
When alcohol is stopped suddenly or is reduced by large amounts over a short period of time, a seizure may occur. This can happen in people with or without epilepsy. The withdrawal seizures are provoked by the alcohol withdrawal and are not due to epilepsy itself.

Alcohol abuse is a medical problem and can lead to epilepsy.

Long-standing alcohol abuse can increase a person’s risk of developing epilepsy.

If you are allowed to drink, use moderation.

Only a few drinks and drink slowly!
Many people with epilepsy are at a high risk of seizures after drinking three or more alcoholic beverages.
Research indicates that adults with epilepsy may have one or two alcoholic drinks a day without worsening their seizures or causing changes in the blood levels of their seizure medications.

Talk to your doctor and health care team about alcohol, seizures, and safety!

Moderate to heavy alcohol use is never recommended for people with epilepsy.
Alcohol and some seizure drugs have similar side effects. Using both at the same time can lead to bothersome and potentially dangerous problems.
Driving would be especially dangerous since both alcohol and seizure medicines can affect your awareness, reflexes, coordination, and ability to drive safely.