Excessive alcohol consumption has been associated with greater seizure frequency in people with epilepsy, especially in people with types of epilepsy that don’t respond well to antiseizure medications.People with a history of alcohol misuse seem to have a greater risk of developing sudden unexpected death in epilepsy (SUDEP) than people with epilepsy with no history.
Alcohol as an epilepsy trigger
Alcohol may contribute to seizure development by directly causing changes to your brain or indirectly by promoting:
- dehydration
- changes to your sleep
- causing changes to your blood sugar levels
- interacting with your medications
Alcohol usually doesn’t cause seizures while you’re drinking. It usually causes seizures once you stop, and consuming higher amounts of alcohol seems to be associated with a higher risk.In a 2018 study in which 204 people with epilepsy reported consuming alcohol in the last 12 months, researchers found that seizure worsening related to alcohol consumption was reported in 18.1% of these people.The amount of alcohol intake before alcohol-related seizures was at least 7 standard drinks, or the equivalent of 1.4 liters of beer or 700 milliliters of wine. In almost all cases, seizures occurred within 12 hours of stopping alcohol consumption.Having generalized genetic epilepsy was associated with almost a 6 times increased risk of developing alcohol-related seizures. Chronic heavy alcohol use was associated with an almost 9 times increase.
Long-term alcohol consumption and risk of epilepsy
Long-term heavy alcohol consumption seems to be associated with a higher risk of epilepsy.In a 2022 review of 8 studies, researchers found that the risk of epilepsy was 1.7 times higher (95% confidence intervals from 1.16 to 2.49) in people who consumed alcohol compared to non-drinkers.The researchers also found that the risk of epilepsy increased as alcohol consumption increased. According to the researchers, these results are consistent with previous studies.Prolonged drinking can lead to compensatory changes in your brain, such as the down-regulation of GABA receptors and increased expression of NMDA receptors.These changes can promote seizure activity in people with and without epilepsy during periods of alcohol withdrawal. Seizures occur in about 3% of cases of alcohol withdrawal.
Alcohol withdrawal syndrome and risk of epilepsy
Alcohol withdrawal syndrome is a condition that occurs after an abrupt stopping of heavy drinking in people with alcohol use disorders (AUD).The condition may initially cause minor symptoms such as anxiety, headache, tremors, stomach discomfort, and insomnia. It may then progress to more serious symptoms such as:
- epileptic seizures
- hallucinations
- polyneuropathy (damage to peripheral nerves that can cause issues with sensation, coordination, or other body functions)
- dementia
- coma
Because of the risk of seizures and other serious symptoms, detoxing from alcohol should only be attempted with medical support.
Alcohol and risk of SUDEP in a person with epilepsy
SUDEP is the sudden and unexpected death of a person with epilepsy who is otherwise healthy without a known cause. The risk in people with epilepsy is roughly 1 in 1,000 people per year.In a 2020 study, research found that the risk of SUDEP was twice as high in people with a history of alcohol dependence or substance misuse disorder.In another 2020 study, researchers found that people with epilepsy were more 5 times more likely to die from alcohol-related causes than people without epilepsy.
Does dehydration cause seizures?
Alcohol is a diuretic, which means that it promotes water loss by increasing urine output. It can make you more prone to dehydration. Dehydration is a common seizure trigger for people with epilepsy.
Risks of drinking, even in moderation, with epilepsy
According to the Epilepsy Society, consuming alcohol may make your epileptic medications less effective and may make the side effects of your medications worse.The leaflet that comes with your medications can advise you on whether it’s safe to mix your medication with alcohol.Consuming alcohol in large quantities for extended periods seems to increase seizure frequency and might increase your risk of SUDEP.
Alcohol and antiseizure medications
Alcohol and some antiseizure medications can have similar side effects, and taking them together can cause potentially dangerous complications. It’s especially dangerous to mix them when driving.It’s important to always talk with your doctor about whether it’s safe to consume alcohol with your medication.Medications such as clonazepam and lorazepam are benzodiazepines that can cause a life threatening interaction when mixed with alcohol.
What are the recommendations for alcohol use with epilepsy?
Most health experts recommend that people with epilepsy avoid consuming large amounts of alcohol. For example, the Epilepsy Foundation recommends:
- avoiding binge drinking
- avoiding abusing alcohol
- looking for help if you have an alcohol problem
- drinking alcohol in moderation if you do drink
The Centers for Disease Control and Prevention (CDC) recommends that if you don’t currently drink alcohol, you should not start for any reason. Their stance is that drinking less is always better for your health than drinking more, but even moderate drinking may have risks.Before taking your medications, it’s a good idea to check with your doctor or your pharmacist to see if it’s safe to mix with alcohol.
Takeaway
Consuming alcohol seems to be a common trigger for seizures in people with epilepsy.Your risk of developing seizures seems to increase with an increasing amount of alcohol. Seizures often seem to develop in the hours after you stop consuming alcohol.Medical professionals often recommend that people with epilepsy avoid or consume a moderate amount of alcohol. If you do drink, avoid binge drinking or chronically high consumption, which may help reduce your seizure severity or frequency.
