Epilepsy is defined as a spectrum of disorders that involve the central nervous system (brain and spine). The seizures that occur in epilepsy are caused by abnormal brain activity. These seizures may cause people to have unusual sensations or emotions, behave in unexpected ways, or experience convulsions or loss of consciousness.
An epileptic trigger is anything that brings on a seizure. Some common epileptic triggers are physical or emotional stress, eating certain foods, flashing lights, and even lack of sleep. But one of the most discussed triggers on MyEpilepsyTeam is alcohol. Let’s take a look at the relationship between alcohol and seizures to shed some light on why drinking is a potential trigger.
Many people diagnosed with epilepsy have been told that alcohol and epilepsy should never mix because alcohol can trigger seizures. Many doctors and pharmacists recommend total abstinence from drinking, if possible.
Some members of MyEpilepsyTeam know from experience that alcohol use is a trigger for them. As one member wrote, “My first seizure was with my first time being drunk. People used to tell me it wasn't worth it, but I was young. Now, I know it’s not worth it.”
However, other people with epilepsy find they can drink moderately without triggering a seizure. In fact, research shows that a drink or two does not increase seizure activity. Electroencephalogram (EEG) tests show brain activity remains the same, as long as the amount of alcohol ingested is small.
As another MyEpilepsyTeam member advised, “It can depend on the person. I can have one beer or one glass of wine and be OK, but almost no more. However, I would err on the side of caution and not drink at all.”
Others drink without concern for seizures because they know that alcohol is not a trigger for them: “I've been told that I shouldn't drink because liquor can cause seizures,” one member wrote, “but it has never been true for me.”
When seizures do happen as a result of alcohol, they occur within six to 72 hours after drinking. They do not generally happen while a person is drinking, or even within a few hours of stopping. For this reason, if you do choose to drink, it’s important that you pay attention to your seizure activity for up to three days afterward.
Clearly, people diagnosed with epilepsy have different answers to the question, “Does alcohol affect epilepsy?” This can be confusing — especially if you or someone you love has been newly diagnosed with epilepsy and is deciding whether or not to drink. Luckily, current research can help you make wise decisions about your relationship with alcohol.
The answer to whether alcohol can trigger seizures is more complex than you might think.
Binge drinking has been found to trigger seizures. Binge drinking is defined as a pattern of drinking that brings blood alcohol concentration to 0.08 percent or higher. This means consuming roughly five or more drinks for a man, or four or more drinks for a woman, in about two hours.
In one small study from 2018, people with epilepsy who reported seizures after drinking had consumed seven or more standard-sized drinks before their seizures occurred. Nearly all of the seizures occurred within 12 hours after they stopped drinking. Furthermore, seizures seemed particularly likely if the participants did not regularly drink that much alcohol.
Some MyEpilepsyTeam members have seen this occur firsthand. One mother whose son has epilepsy wrote, “My son had a seizure last weekend, and I have had such bad anxiety that I swear I have a harder time than him! He is 25, went out drinking with friends the night before, and binge-drank. I’m assuming this brought on the seizure.”
While the study did not indicate light to moderate drinking as a potential seizure trigger, even one alcoholic drink may affect some people enough to cause seizures. As one MyEpilepsyTeam member wrote, “I have a seizure every time I drink, even if it’s just a wine cooler.”
It’s important to note that it’s not just the alcohol itself that can cause seizures. Binge drinking is associated with other seizure triggers, including disrupted sleep cycles. (Lack of sleep is a common trigger for many people with epilepsy). Because of this, it’s possible that a seizure that seems to be triggered by alcohol may actually be caused by another trigger.
Ultimately, everyone’s brain is different and responds to alcohol in different ways. You may choose to try a drink or two of alcohol in a controlled environment to find out if it triggers seizures, or you may decide drinking is not worth the risk of having a seizure at all. It’s important to discuss drinking with your doctor, especially as it relates to any medication you may be taking.
Even if alcohol itself doesn’t trigger your or your loved one’s seizures, it’s important to understand whether your antiepileptic drugs (AEDs) are compatible with alcohol.
Some AEDs have side effects that include lowering tolerance for alcohol. This means a person will become intoxicated faster than they used to before they were on the medication. This rapid intoxication can surprise a person and cause them embarrassment, stress, and anxiety — which can, in turn, trigger seizures. Some people with epilepsy who are legally allowed to drive should consider the increased potential for impairment due to the mix of alcohol and their AEDs, compared to others who drink the same amount but aren't on medication.
Most of these antiepileptic medications also have side effects that mimic those of alcohol. They may slow down central nervous system responses, make a person sleepy, or cause parts of the brain to work differently. If you research a medication and these symptoms show up, it’s likely that AED will lower your tolerance for alcohol, too.
As one MyEpilepsyTeam member recommended, “You can look up your medications on the internet and find out if they have any adverse reactions to alcohol.” Another noted, “It would be wise to speak to your pharmacist about it. They know more about the medications than the doctors do.” Ultimately, it’s important that you understand the side effects of your medications, as well as how they interact with alcohol, if you choose to drink.
The effect of alcohol on people with epilepsy will vary from person to person, even on the same medication. People with epilepsy who drink alcohol may also be less likely to adhere to their medication schedule. If you are especially sensitive to either your AED or alcohol, it may be best to avoid drinking while taking that particular medication.
Many people with epilepsy have heard that alcohol consumption can change the blood levels of their AEDs. More recent research shows that having one to two drinks a day does not seem to affect these levels in most medications. However, some medications are more likely than others to metabolize differently when alcohol is used. It is important to discuss your individual risk for drinking with your health care team.
The choice about whether to drink alcohol as someone with epilepsy goes beyond, “Does alcohol cause epileptic seizures?” You need to consider more factors than just the alcohol itself — especially your medications. Be sure to ask your doctor about the effects of alcohol on any medications you might be taking.
Alcohol can also cause seizures in a person who doesn’t have epilepsy. This most commonly happens during alcohol withdrawal.
People who drink large amounts of alcohol and suddenly stop are at a higher-than-usual risk of seizures. About 5 percent of people detoxing from alcohol abuse will have alcohol withdrawal seizures as part of the process of quitting drinking. This can happen whether or not a person has epilepsy at the time of the withdrawal. However, people with epilepsy may be more likely to have seizures while going through alcohol withdrawal.
MyEpilepsyTeam members have experienced this firsthand. As one member explained, “The hangover after drinking causes seizures, if epileptic.” Another member added, “The way my doctor explains it is that alcohol basically shuts your brain down when drinking, so even the part of the brain causing the seizures is affected. The problem is, when you sober up the next day, it’s like going through withdrawals.”
It’s also important to understand that quitting alcohol after a period of alcohol abuse or misuse may be harder for people diagnosed with epilepsy than it is for those without it. People with epilepsy may have a higher risk of withdrawal seizures than others.
On MyEpilepsyTeam, the social network and online support group for people with epilepsy and their loved ones, members have discussed alcohol, epilepsy, and seizure triggers.
What is your experience with alcohol and epilepsy? Join the conversation today to share your experiences and connect with others on MyEpilepsyTeam.