Epilepsy and alcohol
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Last updated 23 Mar 2010, review date due 23 Mar 2012
Contents
- Alcohol as a trigger for seizures
- How much alcohol is it safe to drink if I have epilepsy?
- How does alcohol affect anti-epileptic drugs?
- How do my anti-epileptic drugs affect alcohol?
- Alcohol as a cause of seizures
- Can I drink alcohol if I have epilepsy?
- Further information
Acknowledgements
Epilepsy Action would like to thank Professor Jonathan Bird, Consultant Neuropsychiatrist, Burden Centre for Neuropsychiatry, Frenchay Hospital, UK, for reviewing this information.
We’d also like to thank NHS Choices for allowing us to use their alcohol unit tables.
Introduction
If you have epilepsy and enjoy drinking alcohol, you may have some questions about how safe this is. These web pages aim to answer some of the most important questions.
Alcohol as a trigger for seizures
We are all born with a ‘seizure threshold’. People with epilepsy have a low seizure threshold. If you have a low seizure threshold, it means that you are more likely to have seizures than someone who has a high seizure threshold.
Certain things can lower the seizure threshold. Missing anti-epileptic drugs (AEDs), tiredness, lack of food, lack of sleep, stress and alcohol can all trigger seizures.
For some people, the combination of drinking alcohol, having a late night and missing AEDs may well trigger their seizures. For other people, drinking any alcohol can make their seizures more likely.
How much alcohol is it safe to drink if I have epilepsy?
Everyone’s tolerance to alcohol is individual to them. Some people can drink a large amount of alcohol, with apparently few, immediate, ill effects. Other people feel drunk after a small amount.
Many people with epilepsy find that they can drink one or two units of alcohol, without having more seizures than usual.
You can find information about the alcohol units in alcoholic drinks on the NHS Choices website.
For a free booklet about alcohol, contact NHS Choices, Tel 0300 123 1087 or apply online http://www.units.nhs.uk/.
How does alcohol affect anti-epileptic drugs (AEDs)?
Alcohol can make the side-effects of some AEDs worse.
Carbamazepine can cause dizziness, drowsiness or headaches. Adding alcohol to the mix can cause you to have slurred speech, unsteadiness, and tiredness.
If you take primidone or phenobarbital and drink alcohol, the sedative effect of the drug may be increased. This will make you feel drowsy and tired.
If you are dependant on alcohol, it will make it harder to get control of your epilepsy with AEDs.
How do my anti-epileptic drugs (AEDs) affect alcohol?
AEDs can lower your tolerance to alcohol. This means you could be more sensitive to the alcohol, and get drunk quicker than people who don’t take AEDs.
Alcohol as a cause of seizures
People who drink a lot of alcohol over a short period of time are at risk of having ‘withdrawal seizures’. These are seizures that happen six to 72 hours after they have stopped drinking.
People with epilepsy who take AEDs are at higher risk of withdrawal seizures than other people.
Can I drink alcohol if I have epilepsy?
The answer for most people is yes, so long as you:
- are aware of how much you are drinking; and
- take your anti-epileptic drugs (AEDs) as usual; and
- understand that some of the sedative effects of AEDs can be made worse by alcohol; and
- understand that taking AEDs with alcohol can make you feel drunk sooner than if you weren’t taking AEDs.
If you drink alcohol, you should still take your AEDs as you normally would. You are at a higher risk of having a seizure by missing your AEDs than by having one or two units of alcohol.
Further information
You can get further information about any of the issues discussed here from your own doctor. You can also find information at [NHS Choices] http://www.nhs.uk/
Epilepsy Helpline
- UK freephone 0808 800 5050
- International +44 113 210 8850
- Email: helpline@epilepsy.org.uk
- Txt msg: 07797 805 390 info
Twitter Updates
Epilepsy Action blog
Comments
hello im writing about my seizures if anyone can tell me what to do and how i can get back to having a normal life after having a nite on the drink the next day round bout 12pm after having 5-10 hours sleep i have my seizure
Sam, Im 25 and was diagnosed with myoclonic type epilepsy at 24 and prescribed Keppra 2* 500mg per day, thanks for the tip, I will now always make sure I never miss one as I too had the same feeling as you that it feels like its gone away but it just never will. Thanks for the advice!!! Siobhan
Sam you are totally right Keppra rocks. I have had about 4 seizures over 5yrs kept on getting and loosing driving license etc... Got a bit "chewy" if too much booze etc... Couldn't get these "Chewy" totally conscious things under control...
I am switching from tegretol retard to Keppra (also take 200 of lamotrigine twice a day). I started 3 weeks ago and thought I had made the worst mistake of my life. I got married on 24th July and 10 days before took 50mg of keppra and nearly passed out into my dinner at a restaurant. It was like I had been shot full of morphine for the following 3 days. Phoned consultant completely packing myself about passing out at the alter HOWEVER this stuff is amazing once you get use to it. I was up for about 40hrs or so around the wedding, have partied away and and been as sharp as a ninja. I just upped it yesterday to 500mg whilst bringing down the tregatol retard to only 50mg twice a day and am feeling a bit more of this "sleepy-getting-use-to" so may ask consultant if I need more than 500mg as I feel so good.
I found your message very interesting. My son has only just been prescribed and AED, just last week in fact, at the age of 43. The neurologist said that the law has changed and that it is now possible to have your driving licence back after 6 months. I hope this is helpful. It seems that not many people are aware of this change.
john hi im 44 and have had epilepsy since 12 and im 44 now,, i even hate the word for some reason!! iwas controlled for 20 years and a year and a half ago i had 30 in one day bad !!!! lost most of my identity ,got aphasia etc even forgot i drank like a fish in one night !! , anyway my friend who is 60 and the only other person i know with this, has to smoke grass !! he went from 12 a week to 0 for 30 years ! so he smokes everyday! im on the same drug as you among 10 others for different reasons but i understand the will to do stuff is lost !!!! one thing is i used to build models professionally and drink hard while doing it ! now the same model and bottle are sitting on the counter over a year later!,,, im glad here in canada i own my own antique shop and its open from 10 till2 so i get to be and have to be lazy!!!! but i tell you i liked who i used to be ! now i live in a past or try to !, mike
hi im 22 and have had a mild form of epilepsy scince i was 14 the doctors told me it was probably caused from stress i just want to know if you drink energy drinks for a prolonged amount of time could that cause you to fit because i was drinking them continuously at one point and had a seizure in the middle of town and it made me have to wait another year to do my test and i was only a month off.
I'm 29, five and a half years ago I started having fits, out of the blue, no warning, I just wake up with my family around me and it feels like I've had a good sleep!
Within a month I went to see my specialist and he recommended Keppra, I've been taking that ever since, I am able to drink as much as I want when I want, I have recently stayed awake for more than 24 hours and I was fine. I even got my driving license back within two years of my first fit.
Keppra at the time was put to me as a experimental drug, I never tried anything else, and I don't want to try anything else, I take 750mg when I wake up and 750mg before I go to bed. I would recommend it to anyone still having problems with their medication.
Once, because the medication was working that well, I didn't believe I had epilepsy any more, I stopped taking it and within 24 hours I had a fit! this has also happened whenever I have missed two tablets. Needless to say I take it religiously now! even have tablets all round the house to remind me!
Hope this helps someone out there.
I have been diagnosed with epilepsy for about 10 years. I experienced very mild petite-mal seizures in my youth that only happened about once a year and consisted of a quite pleasant feeling of deja vu that lasted perhaps 30 seconds or a minute - they always happened in the morning and I think they were due to having a later than usual night and I never thought anything of them. It was not until I was a student, and was consistently smoking marijuana, that the seizures became more serious resulting in a loss of consciousness and sometimes grand-mal seizures. I found it very difficult to give up marijuana and over the years the length of these seizures gradually became longer and more frequent - sometimes lasting 20/30 minutes. However, for the first time I have been able to give up or greatly reduce the amount I have been smoking over the last few months, and I have some questions relating to this:
I have found stopping smoking has significantly reduced the frequency and length of seizures - almost stopping them completely during the day, however a side affect of this has been that my dreams have become more frequent, vivid, unsettling - often preventing a good nights sleep. It feels to me that my brain, having been numbed for so long by marijuana, is kick-starting back into action with obvious benefits but is unable to distinguish between daily periods of activity and nightly periods of rest. In fact the longer I stay off marijuana the more disruptive these dreams become, and I have found that if I smoke a very small amount it enables me to have a good couple of nights sleep. I know that vivid dreams are a symptom of any marijuana user giving up, but after about 2/3 weeks of not smoking my sleep is so disrupted that I wake up about every 2/3 hours due to these dreams, feeling very tired in the morning, to the point that I often smoke a small amount with the reassurance that I will have a good and welcome nights sleep. Therefore I want to know if these dreams are a result of epilepsy or the marijuana gradually leaving my system, and if the latter is there is a time frame in which these excessive dreams will stop and should I hold out longer in the periods I stop smoking?
I have read that it takes marijuana about 6 months to completely leave someone's system, and I'm not sure whether such a period of disrupted sleep would be more helpful or harmful in the long term.
I am currently taking Keppra but it seems the only thing that effects my sleep or seizures is the amount of marijuana smoked. My doctor has currently prescribed Topiramate to counteract my sleep and he has no knowledge of questions related to marijuana, therefore I am reluctant to try any new medication if my epilepsy can be completed controlled purely by giving up smoking.
Thank you very much for listening to my comments and questions,
Patrick.
I`m a grand mal epileptic who doesnt take seizures anymore. Thanks to herbal cannabinoids i have my life back. Any 1 with a bit of knowledge knows that cannabinoids is an amazing nueroprotectant. So ppl if you are still on big pharmas chemicals and taking seizures then try herbal cannabis! cannabis indica= anti convulsant sativa= anti depressant i also have my appetite back and get a goods night sleep. EDUCATE DONT DESCRIMINATE!
JOHN
I have not taken a drop of drink for 3 years in the hope that it would stop my e. Whilst I can go up to 6 to 8 months without a sz I have not made that magic 12 months to get my driving licence back. I doubt I will ever get my licence back and I will have to accept I will have e for the rest of my life. Certainly no drink has helped and as aside affect I have lost over 2 stone. But not drinking is more socially unacceptable than drinking too much. So its hard not to drink and if I have another sz then I know that no drink has not worked and then perhaps have a drink.
I admit keeping my identity quiet on this one. Regarding drugs I do not take any recreational drugs but in the past I may have. All have undermined medication (although binge drinking has actually proved the worse):
Marijuana: In the UK marijuana is strong and totally at odds with the low THC (stuff that gets you high) epilepsy treatment weed grown in Canada. It will probably bring on un-predictable "phasing out" (unlike alcohol with its usual 72hr delay and following 72hr window of unreliability). Pot takes a while to get out of your system and you should basically not touch it but if you do you should not go anywhere near a car!!
Ecstasy: Again ecstasy you should not touch if you are taking medication. When you take your first 50mg of tergatol retard you tend to experience mild hallucinations out the corners of your eyes and smell vomit. Ironically similar effects to coming down of off a "bad" pill. Our drugs are quite strong, once you have built a regular course of medication you probably won't notice a single ecstasy tablet and therefore why bother taking them.
Cocaine: Definitely do not take cocaine. There is one simple and unplesant effect from cocaine you will hear from people. This is that once in bed that night you will experience short repetitive "jolts" not so much a night seizure or anything but "jolts" that will irratingly wake you up throughout the course of the night. These effects seem to be relatively short i.e. over by morning and presumably effecting you when you brain is more relaxed in sleep. But this is bloody unpleasant and probably awfully bad from you so don't take it.
That is all I have to bring to the table. I guess it is JUST SAY NO!
I'm now 29, but I approached Uni (and indeed the rest of life) in the same way, and found alcohol in large amounts* - and ocassionally some cannabis - for me was fine as long as I had my medication (Epilim Chrono, now 2500mg). From the other accounts I've read on this site, I think I've got a mild form, though.
I am 29 and I had my first seizure of my life two days ago, and I really dont know what caused it but the prior weekend was my birthday and I did drink a lot and take a lot of drugs and I havent really been eating or sleeping that well for a few weeks now, I find it really strange. I appreciate the information and will be staying away from drink and drugs until I get the diagnosis from the neurologist but I really hope this was just a one off, but then my brother and cousin are both epileptic so chances are I may have a mild form. I used to be a frequent user of recreational drugs and drank heavy in my late teens till my mid twenties so I think this may be my kick back now, I am only presuming this is what has caused it.
I was diagnosed at first with TLE in 1994 (I was 15) after a head injury. After a while my siezures stopped to be replaced with hallucinations, mood disorders and I was then diagnosed with Bipolar Affective Disorder. 13 years later I have started having siezures again (very frequent, 15 per day with some status epilepticus). I am taking 2000mg Epilim (1000 bd) with no effect. This has been supplimented with 500mg Keppra which has caused me to go round the twist! I am finding the side-effects unbareable.
Prior to the Keppra I was taking 2000mg per day of Epilim and supplimenting this with some cannabis. I was free of siezures during this time. Anyone had any similar experiences?
replying to the comments of Juliet 6/7/09
i myself do not have epilepsy but my brother may have,he was staying at my house overnight had some drinks in the evening but not that many,we went to sleep about 00.30 hours...but i woke up several times during the night and my brother was awake and was sat up everytime,This led me to believe that he had no sleep or very little that night.also my brother does not have a balanced diet he hardly eats anything.Anyway i woke up about 6.30 in the morning made us both a brew and a cigarette and then he told me he had a strong sense of deja veiw and that he had been hear before and shortly after that he froze,did not move a musule for two minutes,and then went into a fit.
therefore i conclude that,as well as many of the articles above,that lack of sleep,bad diet or restricted diet and alcohol can all be contributing factors into people having fits.
Three years ago I had been out for lunch with my wife and we had some wine (two glasses each), with our lunch. The next thing I knew I woke up in Hospital, upon asking the Doctor what had happened he told he that it appeared to be an alcoholic seizure! They gave me some tablets and I had to go and see my GP. He gave me sodium valporate (500mg twice a day), this seemed to work for about five months, until I had another seizure. I was at my mothers when it happened and I had cut my head very badly, so she got an Ambulance, and came to the Hospital with me. The Doctor looked up my records and informed my mother it was an alcoholic seizure.
She told him I had not drunk any alcohol since the first seizure I had ever had, which was five months ago. Because I was in A& E, they moved me up to a ward and a consultant came and talked to my mother as I could not remember anything at all. After listening to her, as she saw what happened; he concluded I was in fact Grand Mal epileptic, and he wanted me to go to another Hospital, which I did.
I had all the tests done and they sent me back to my GP who put my AED up to two 500mg in a morning, and two at night! I was fine for awhile then I had a series of seizures, and the Hospital were puzzled so sent me to see a Neurologist. When he looked at my military records, he noticed that I had PTSD, nobody had ever told me that.
So he concluded that high stress could cause the onset of my seizures, as I was going through a lot of stress at the time, he told me to slow down, and arranged to get me help for
my PTSD. I asked him about alcohol and he told me small amounts, as long as it did not affect me should not matter that much, but to write down what I had drunk and if it made me have a seizure or feel strange, not to have it again.
The things that give me instant headaches are red wine or chemical lager. Guinness is fine with me, as a I am an occasional lunch time drinker, you can't drink much Guinness and eat. The worse thing is coffee, two cups and anything can happen.
Luckily now my GP has seemed to get the balance right with my AED tablets, I have not had any trouble for over a year.
I think you just have to be sensible and careful, and find out what suits you. If it does not agree with you leave it well alone.
I am 45. First seizure at 26. Have recently accepted after years of self denial that the majority of seizures follow a heavy drinking session. I have been a week-end binge drinker most of my adult life and couldn't understand why the majority of the time i was unaffected.This I think led to the self denial. I can safely say ,however that the older i get , the less my tolerance for heavy drinking. In earlier life I would get a "warning sign" and be able to sleep it off before a full seizure occured. Now I find that the less quality of sleep you get after a heavy night on the booze can really adversely affect me. Only other causes seem to be lack of quality sleep even after no alcohol the night before which can sometimes be problematic for a shift worker like myself.
I have been solely a beer drinker for many years after finding the strength of spirits really made things worse. Guess it's just not worth it or fair on the people around you who are left to pick up the pieces, You see I never saw it happen and often woke in a confused state and little recollection , but have scared the hell out of friends and family.
I'm 39 and recently had MUMPS. During the illness the doctor gave me blood tests.....and discovered that my Phenytoin levels were very low. (usually 40 - this time 17).....I didn't think anything of it until I went back to work and had a seizure!! (apparently the illness can mess up your blood levels etc etc)
I'd had 3 glasses of CAVA at the weekend (seizure happened the Monday).....I never usually drink! apparently this had lowered the levels even further.
It really scared me.
Neurologist has now said NO ALCHOHOL EVER AGAIN!
Thats fine with me....I came round wedged in between a wall and a portable radiator....bashed my head several times, bit my tongue several times, black eye.....(mild) and I've hurt my neck!!!!
I'm now about to get another blood test done - and fingers crossed, the levels are what they should be.....
i discovered i had epilepsy at the age of 16. i am now 24 yrs old and am studying a health course 200 miles away from my home. no one in my family has ever had epilepsy or blackouts and no one knows where it come from. my mother shelters me and doesnt want me out past 12, doesnt let me drink not even alchopops and wont listen to me. i drink when i am out and have only ever had 2 fits following a night out and in 8 yrs of drinking i think thats good. is there any way of making my mum understand so she can let me be a normal 24 yr old student?
I agree with Julie,
I am 33 years old and was diagnosed with epilepsy when i was 20.I have never let my epilepsy rule my life and enjoy nights out with my husband and friends like every other person.My epilepsy is very strange! i can go 2 years without a fit and then have 3 or 4 a few weeks apart.I know i drink too much but i find that if i stay in bed all day after a night out im okay.I do realise that everyones seizures are different, it would be great if everyone could take a small pill and we would all be cured! The side effects of the medication are awful,I take carbamazepine and some days i feel like a zombie and iknow it's hard for people to understand how bad you feel, they think you are a little bit lazy! some days i find it difficult to get out of bed never mind go to work.I would like to wish everyone good luck and only you know your own body and the limits you can take it
.
I am 24 years old with mild epilepsy and have never let myself be held back by it. My seizures/absences can be triggered by lack of sleep,stress or missing a dose of my Epilim. Throughout my days at Uni I had many nights out drinking copious amounts of alcohol and 98% of the time all was well as long as I had the following day to recover by sleeping. Recently I have tried a few different recreational drugs and whilst I know that I wont delve deep into the drug scene I have had no issues and these occasions where I use drugs with reliable friends only happen about once every two months. I think that everyone has to know their limits as every single person's Epilepsy is different but think its very important not to let it rule your life,its too short.
If you have epilepsy don't drink heaps of alcohol in a short period of time. i drank bout 15 drinks in 3 hours and started to have seizures in the back of the ambulance. My heart almost stopped and the only way they kept me alive was with adrenaline. Its probably the same for people without it but be careful if you have it
I only have mild epilepsy but my symptoms leading up to my diagosis were stong feelings of deja vue about things that have never happened...
When I was getting a hangover having drunk too much the night before, I was having the same deja vue feelings... I had a chat with my doctor about it and he explained that too much alcohol makes the body feel as if it has been starved of medication and therefore can lead to a fit. Also, the lack of sleep is a contributory factor.
One can look at the bright side, it takes hardly any alcohol to get me drunk now due to my epilepsy and apparently this is very common in epileptics... therefore a night out is much cheaper!
hi im 21 i have only had 4 fits and these have been in the last 4 years. In every case of having a fit i have drunk heavy the night before. These nights out drinking also mean late nights so i feel it may be to do with the withdrawal of alchol does this sound right?
hi there im 16 going on 17 years old and i have JME, im starting epilim after two years without fits and suddenly my fits have started again, after heavy drinking during my time of medication and heavy smoking ( skunk ) where i had no siezures, i began fitting during my examinations, where my docter has told me to go back on seizures for my safety. however i want to be able to enjoy my social life like before and still if not get smashed everytime, feel a little buzz every now and then and enjoy my summer holidays like any 17 year old would, do you think drinking everynow and then and smokking cannabis would mess me up, bearing in mind when i was sharing a litre of whisky between one person, i was completely siezure free, or now that im on AEDs i should stop completely ? thank you
Hello my fellow believers.
My name is John and i have Epilepsy from Temporal Lobe Scaring I have sufferd with this for about 7-8 years. With a view that Sodium Valporate (Epilim) just makes me a very suffer a anxious and unstable personality especially made worse by the fact that I suffer with A.D.H.D. this is a very stressful chemicalto tke and personaly I feel its uses are overrated. I have also smoked Cannabis for the most part of my "adult" life and about 2+1/2 years ago I raed on the internet that Cannabis may have positive effects on People with Epilepsy and also ADHD so I started smoking it on a daily basis. Scince then I have had two 3 month stops off it and this is where my Epilepsy really started showing its true colours. When I dont take it I have at least a fit a week but while on Marijuana it is more like 10-12 days which is by the best of standards a good decrease. So with a plant which has not really killed anybody directly should we start thinking logicly about this and get some people like me into a testing center to see what the truth is behind Cannabis , not just its effects on a person but its posible economic profits and losses which would be brought about by legalising it either in full or just for medicinal purposes and too answer the Question "HOW DANGEROUS IS CANNABIS AN WHAT ARE ITS RISKS---THE TRUTH"
Your Husband sounds very much like mine, he has had 3 fits in the space of 2 years, but my husband is in his 30's. It started after a bottle of vodka, well, 2 days after. Then he was fine for months until the bottle of whisky. He wasn't really drinking the night of the 3rd one, it just happened. My husband has also been smoking weed since he was 18, I believe that dampened the symptoms for years, but the heavy drinking woke it up. He still drinks lager and has stupid days, but pays for it the next day!! We all do. He is on epilim 500, twice daily.Sometimes he misses them out because he feels so bad taking them, he has to go back to bed on a morning til lunchtime because he is so tired,if he is at work on a morning he sleeps for 3 hours when he comes home. does this happen to anyone else ?? He even thinks his consultant has it all wrong and he doesn't have epilepsy because nothing showed up on the scans. It drives me mad, because it's me that has to look after him when he's indulged himself, If anyone has any tips, I would be grateful.
My husband (just gone 64) was diagnosed with epilepsy in July 07 after his second grand mal - both early morning at home. He has been seizure free for 18 months (since Sept 07 seizure in early hours after son's wedding) and was on Epilim 500 twice a day. He is and always has been a regular and sometimes heavy drinker, he eats well, is reasonably active (a semi retired farmer, builder, goes walking, does Sudoku, brain power still functions well, as I know cos mine's fading and I'm younger!).
He had umpteen tests after both the first and second seizures and everything showed him to be very healthy, just very overweight. The doctors advised him to cut down on his alcohol, but did not really explain why, apart from the general health aspect.
Anyway, he's recently had another early morning seizure which has been a shaker for us both as we thought all was settled. Apart from the Sept 07 seizure, none of the other three followed a heavy drinking session.
We know that alcohol and AED can be counter effective.
But I've read that 'withdrawal' seizures can happen - when someone who drinks a lot then doesn't have any or much alcohol for a short period.
Could this be an explanation?? !!!
If not, is there perhaps no explanation and we'll just have to live with epilepsy and its uncertainties?
Hope you can help us help ourselves.
Thank you for reading this.
i hqve found out that cannabis and drinking heavyly every now and again does not affect my epilepsy but i hav a minor form i have been doing cannabis on and off for a year and drinking for longer and i havent had a sezuire in 8 months
Hi i would like to comment on the recreational drug section, and thanks for putting he artcle up, as its good to know a little at least. i have Juvenile myoclonic epilepsy (JME) and i have been using weed before i was diagnosed at 15 and i can honestly say serizues come less often, i think helps relax me on an even level but it only smoke it a couple times a week at the most, i think smoking it like cigarrettes is where the real problems start . my AEDs seem to work well, definately post drinking. i think its knowing your own limits. someone said about not 'binge' drinking but, I am 23 and was a student to recently. i think as long you are not completey idiotic and know when to say to no the next drink, you should fine. i have recently started to take other subtences in small portions, and so far it has been fine, but thats just me. i do not think i will ever delve to deep into the drug culture. i spoke a friend who is a very good doctor who told the worse thing you can touch is ketermine, as its effect on the brain really make things pear shaped. i honestly think the most important think i have learnt is not let myself be held back by this. i hope i have helped a little
Dave