If you have epilepsy, alcohol consumption can have serious consequences. Although there seems to be no increased risk of seizures for persons with epilepsy who consume less than 50g (approximately 2 drinks) of alcohol a day, there is a 15-20 times increase in risk when consuming over 200g a day. As such, binge drinking and alcohol withdrawal can cause seizures and even status epilepticus. In small amounts, alcohol does not cause any adverse effects for people with epilepsy; in fact, a small amount of red wine at dinner can be beneficial to one's health. Small amounts of alcohol do not alter levels of medication in a person's blood.
In nearly all cases of seizures triggered by alcohol abuse, it was the withdrawal process that caused the seizures, not the drinking itself. Alcohol related seizures often occur within 6 to 72 hours after drinking. The majority of alcohol related seizures occur around 8 hours after drinking. Alcoholism or severe alcohol abuse may cause the development of epilepsy in some individuals. Repeated alcohol withdrawal seizures may make the brain more excitable, causing a rapid misfire of neurons resulting in a seizure. After fully withdrawing from alcohol, these "alcohol seizures" continue as the brain is left in this hyper-active state.
Alcohol and Anti-Epileptic Drugs (AEDs)
As with many other prescription drugs, alcohol increases the sedative effect of many AEDs while also significantly lowering one's tolerance to alcohol. Rapid intoxication can be very harmful, as many of the side effects can be made worse by these medications. The rate of absorption of AEDs in a person with epilepsy has been shown to differ quite substantially, depending on the drug type:
- The effects of carbamazepine and phenobarbital are reduced when alcohol is ingested.
- The mixture of divalproex sodium with alcohol causes severe depression of the central nervous system.
- Alcohol will upset the blood serum level of phenytoin: acute alcohol intake will increase the blood serum level, while chronic alcohol intake will decrease blood serum levels.
Things to keep in mind
- People with epilepsy are at a much higher risk of having a seizure after consuming 3 alcoholic beverages.
- Long-term alcohol abuse is thought to be a factor in developing epilepsy later in life.
- Drinking alcohol while using AEDs can severely lower tolerance and cause adverse effects such as nausea, dizziness and fatigue which can be extremely dangerous.