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Alcohol withdrawal is a series of symptoms that can appear hours to days after someone who has been drinking heavily stops or sharply reduces alcohol use, and it may cause seizures.
Alcohol withdrawal seizures are usually triggered by withdrawal itself and do not mean a person has epilepsy.
However, people with epilepsy may face added risks during alcohol withdrawal, especially if they also stop taking their anti-seizure medication. Here’s what you need to know.
What Is Alcohol Withdrawal? Alcohol withdrawal can happen when someone who is a chronic drinker stops drinking a large amount of alcohol or significantly decreases their alcohol intake.
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Alcohol withdrawal usually happens after a person has been drinking heavily for more than two weeks so that their body has become physically dependent on alcohol.
According to Cleveland Clinic, a large quantity of alcohol is five or more drinks in one day or 15 or more drinks in one week for an adult male. For an adult female, a large quantity of alcohol is four or more drinks in one day or eight or more drinks in one week.
Alcohol slows down your central nervous system (all of the nerves in your brain and spinal cord). The central nervous system allows us to:
That’s why people sometimes don’t act like they normally do after drinking alcohol. They might report blurred vision, have trouble controlling their moods, or be unsteady on their feet.
The central nervous system works extra hard to overcome the sluggish effects of alcohol. When someone drinks a lot of alcohol over a long period of time, the central nervous system adapts and treats its hyperactive state as the new normal.
When alcohol is suddenly no longer consumed, the central nervous system continues in overdrive. This can cause a variety of symptoms known collectively as alcohol withdrawal.
Alcohol withdrawal symptoms may appear as soon as six hours after the last drink. Usually it starts with relatively mild symptoms like headache or irritability.
Withdrawal symptoms can become more severe over time. Serious complications can include seizures, hallucinations, and alcohol withdrawal delirium, also called delirium tremens. These complications can be life-threatening and need urgent medical care.
Symptoms of alcohol withdrawal and delirium tremens may include:
The timing of alcohol withdrawal symptoms can vary. Seizures often happen within the first 48 hours after the last drink, while alcohol withdrawal delirium may start later and can last for several days.
Seizures are among the most serious alcohol withdrawal symptoms. Alcohol withdrawal seizures do not happen to everyone who goes through withdrawal. The risk is higher in people with more severe withdrawal and in those who have had withdrawal seizures before.
The seizures tend to occur about seven to 38 hours after the last drink, and multiple seizures are more common than single seizures. Repeated episodes of alcohol withdrawal can make future withdrawal more severe and may increase the risk of seizures.
Seizures from alcohol withdrawal are typically generalized tonic-clonic seizures, which means the electrical activity spreads across the brain (generalized) and causes a sudden loss of consciousness, stiff muscles, and repeated jerking movements.
Alcohol withdrawal seizures are usually considered acute symptomatic, or provoked, seizures. This means they happen because the brain is reacting to suddenly losing the effects of alcohol. Having a withdrawal seizure does not by itself mean a person has epilepsy.
People can have alcohol withdrawal seizures even if they’ve never had a seizure before. Repeated alcohol withdrawal may make the brain more likely to have seizures, but withdrawal seizures do not necessarily mean a person will develop epilepsy.
Alcohol withdrawal treatment may involve multiple medications or therapies. Symptoms can change rapidly, so it’s important to seek immediate medical care if you suspect alcohol withdrawal. Don’t attempt to wait it out or self-medicate.
Benzodiazepines are commonly used as first-line medicines to prevent and treat severe alcohol withdrawal and withdrawal seizures. People going through withdrawal may also receive thiamine, also called vitamin B1, because heavy alcohol use can lead to a serious thiamine deficiency.
Some evidence indicates that drinking alcohol can lower seizure threshold (how easily a seizure can be triggered in the brain). Small amounts of alcohol seem to be relatively safe for people with epilepsy, but sudden binge drinking increases seizure risk, not necessarily while drinking, but after stopping.
The safest course of action is to avoid alcohol altogether. But that’s not always easy to do. Can you accept a glass of champagne at a wedding? Or go on that wine tasting tour? Your neurologist can give a recommendation based on your medical history, but here are some general evidence-based tips.
The definition of “too much” varies based on your drink’s alcohol concentration, the sex you were assigned at birth, your weight, your medications, how much water and food you’ve recently had, and more.
Try just one or two servings of whatever you’re drinking. At three or more drinks, you face a higher risk of seizures.
Ask a pharmacist or healthcare provider how your medications interact with alcohol before you start drinking. Some anti-seizure medications can cause serious side effects when they interact with alcohol. You might struggle to breathe, feel extremely sedated, or face an increased risk of liver damage.
Don’t skip your epilepsy medications in order to drink, as this may trigger seizures. To minimize health risks, have a nonalcoholic drink instead.
Getting deep, restful sleep helps decrease the risk of seizures. While alcohol does cause drowsiness and can make it easier to fall asleep, it ultimately worsens sleep quality and can lead to insomnia in the middle of the night.
If you’re going to drink, finishing several hours before bedtime may help reduce alcohol’s effects on sleep. Drinking water can help prevent dehydration, but it doesn’t make your body remove alcohol faster.
On MyEpilepsyTeam, people share their experiences with epilepsy, get advice, and find support from others who understand.
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I had generally been fine with one drink at night. Recently I was out with old friends and had several drinks (much more than my self imposed limit) and I paid for it the next day with a big seizure… read more
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