Alcohol, recreational drugs and epilepsy
It is a fact that alcohol and, increasingly, recreational drugs, are part of many people's lives. Not surprisingly Epilepsy Action receives many enquiries from people anxious to know the facts about these in relation to epilepsy. In providing this information, Epilepsy Action is not condoning, or condemning, the use of any of the substances mentioned below. Our aim is to answer the questions many people ask us and to provide the reader with clear, unbiased information.
In our information, we talk about the 'seizure threshold'. Each of us is born with a different level of threshold. Those with a low seizure threshold are more likely to experience seizures than those with a high seizure threshold. Additionally, certain things can lower the threshold people are born with. These can include damage to the brain by whatever cause and the use of certain substances, such as those detailed below.
Epilepsy and alcohol
The issue of epilepsy and alcohol consumption can be very confusing. Is it safe to drink with epilepsy? Can alcohol cause epilepsy to develop? Excessive drinking can make seizures more likely because of the effect of the alcohol on the brain. It can also interact with anti-epileptic drugs making them less effective. Late nights, missed meals or missed dosages of anti-epileptic medication, all of which can be associated with heavy drinking, can be triggers for seizures.
Assessing the risk
Half a pint of standard strength beer, one standard glass of wine, a small glass of sherry or a single pub measure of spirits each contains about one unit of alcohol. Most people with epilepsy find they can have one or two units of alcohol, perhaps more, without this increasing the chances of having a seizure. Other people find that even a small amount of alcohol triggers their seizures and consequently may choose not to drink alcohol at all.
Anti-epileptic medication
Having epilepsy and taking anti-epileptic drugs (AEDs) doesn't necessarily mean you can't drink alcohol, but it's important to bear the following facts in mind.
AEDs can make you more sensitive to the effects of alcohol and alcohol can exaggerate some side-effects of AEDs. If your AEDs make you feel sleepy, dizzy or light -headed for example, alcohol might make this worse.
Drinking a lot can cause you to have 'withdrawal seizures'. These seizures may begin within seven to 72 hours of stopping drinking.
It's important not to deliberately miss taking your AEDs because you want to drink alcohol. You're far more likely to have a seizure by missing your AEDs than by having an occasional drink.
Can alcohol cause epilepsy?
A 'binge' on alcohol can cause a seizure, even in people who do not have epilepsy. Such seizures can be due to alcohol withdrawal, toxic effects of alcohol, too much fluid, and metabolic changes in the body. Withdrawal seizures may begin within seven to 72 hours of stopping drinking.
Conclusion
Alcohol can make seizures more likely to occur. It can make drug side-effects worse and anti-epileptic drugs can exaggerate the effects of the alcohol. Excessive or heavy drinking is likely to increase the risks of seizures and lead to other health problems. Taken in moderation, however, many people with epilepsy will be able to enjoy an alcoholic drink. Other people will have decided that alcohol is not for them, perhaps because they don't want to take the risk, or experience has taught them that even moderate drinking can make their epilepsy worse.
Epilepsy and recreational drugs
This section is intended to provide factual information on the use of non-prescribed drugs and solvents in relation to epilepsy.
Marijuana (cannabis, grass, pot, hash, smoke)
Marijuana is available in many different qualities and there is a wide variation in how much people consume. Some reports suggest that it can reduce seizures. Other reports point to an increase in seizures.
Ecstasy (also known as Es)
According to research, ecstasy increases the amount of certain chemicals found in the nervous system, resulting in over stimulation. One of the results of this stimulation can be seizures. Additionally, ecstasy is often taken alongside other illicit drugs and there is some evidence to suggest that a combination could trigger seizures. Taking ecstasy can lead to dehydration. This may be as a result of being hyperactive and, for example, dancing all night. Problems may arise if someone with epilepsy starts to drink excessive amounts of water as this may lead to water intoxication, which in turn could cause a seizure.
Heroin (smack, scag, brown)
Heroin, in itself, can cause seizures. More often, seizures are related to taking other illicit drugs or alcohol at the same time or to the overall effect of a heroin overdose. As heroin can be administered intravenously, some people may experience seizures as a result of an infection from using dirty needles. And as heroin can be mixed with other unknown substances, these may, in themselves, also trigger seizures. Some of the medications used in treating heroin addiction can have an effect on the seizure threshold. People with epilepsy seeking help for heroin addiction should discuss their treatment medication with their doctor.
Amphetamines (speed, pep pills, uppers)
Amphetamines can cause seizures when abnormally high dosages are used, causing intoxication. Amphetamines are also sometimes taken with other illicit drugs which may be known to trigger seizures. As amphetamines are a stimulant, people may use them to keep themselves awake, for example, if they were going clubbing until the early hours of the morning. The resulting lack of sleep can be a trigger factor for many people with epilepsy.
Cocaine (coke, crack)
Cocaine can provoke seizures in people who do not have a diagnosis of epilepsy, as well as making someone's epilepsy worse. This is because cocaine can lower the seizure threshold, or cause other medical problems which can lead to seizures. Seizures can also occur as an indirect result of taking cocaine such as lack of sleep, lack of food and not taking anti-epileptic medication as prescribed.
Solvents
Evidence suggests that long term use of solvents can cause brain/nerve damage which could in turn cause epilepsy. There is also a strong possibility that sniffing solvents over a longer period of time could make someone's epilepsy worse.
Temazepam
Taken in large quantities, this drug may provoke seizures as a result of the toxic effects in the body.
Steroids (Anabolic steroids, used in sports)
Anabolic steroids should be used with caution in people with epilepsy.
Tobacco
There is no evidence to suggest that smoking cigarettes or cigars can trigger a seizure. However, some nicotine preparations, used to help people stop smoking, should be used with caution as they can have a side-effect of convulsions. If someone with epilepsy wants to stop smoking, before buying any nicotine preparations, they should discuss this further with their doctor.
Caffeine
Caffeine in its pure form can lower a person's seizure threshold. There is also some research that suggests that drinking excessive (very large) amounts of caffeine can increase the risk of seizures in people with epilepsy.
However there is no evidence to suggest that drinking a few cups of coffee or tea each day can trigger a seizure.
Conclusion
Recreational drugs can be made up of many different ingredients. These drugs are illegal and there are no regulations to control quality. Heavy drug taking often leads to other problems such as not getting enough sleep, and not eating properly. These in themselves are common triggers of seizures. These are the facts. Each person with epilepsy will have to decide for themselves whether they wish to take the risks involved.
Further information or advice about any of the issues discussed here can be sought from your doctor, epilepsy specialist nurse or organisations such as Alcoholic Anonymous, the National Drugs Helpline or Quitline.
Epilepsy Helpline
- UK freephone 0808 800 5050
- International +44 113 210 8850
- Email: helpline@epilepsy.org.uk
- Txt msg: 07797 805 390 info
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Comments
I would like to comment on the "Alcohol" issue on your helpline.
I totally agree with most of your comments. What I have found from having a few drinks is that a person must know when to time one's A.E.D.'s if you are fit or allowed to have a few.
I can never take my medication before or during a few drinks, only after. This is not the same for everyone!
Whatever a person does......."Do Not" binge drink! The effect on the liver with your AED's can be terrible!
That's a very informative article and thank you for posting it, I needed this information for my sibling, he has this condition and he also had a drug history, he only stopped because the condition got worse but still he needed a drug detox. Now that he is feeling better I am worried that he didn't understood the gravity of his drug behavior and this article will help me to make few things clear for him.
That is why in an alcohol rehab program we must have special psychopedagogy professionals that know how to apply certain techniques in order to make people realise what the dangers of alcohol are and of course special therapy techniques for special needs people.
I completely agree with Declan with the alcohol issue. I'm 20 years old and a student at uni so going out with friends, drink etc is obviously a big part of the social life but i've always found that i have to take my AED's post drinking because before or during normally makes me feel worse.
It is frustrating going to clubs that have strobe (im a photosensitive epileptic as well as having fits being brought on by stress and sleep deprivation) however my doctor said in a situation like that rather than closing your eyes put one hand over one of your eyes because it is apparently more affective in blocking the strobe from your eyes/nerves (something like that :) )
Hope this helps if anyone else gets caught in sticky situations like that!
I have been a pot head for many years and IM CERTAIN its the weed that causes it and everytime i give it up my fits stop... take it from me its not worth it
Question: I take an anti-epileptic drug (lamotrigine/lamictal) for bipolar disorder. i.e. I have never had a seizure, and I was wondering if anyone knows where I can find information about the drug-drug interactions particularly with alcohol and other recreational drugs in terms of using AEDs as mood stabilizing medications? Any help would be much appreciated! Thus far I haven't noticed any major interactions with alcohol except I feel drunker quicker if I accidentally take my lamotrigine later in the day (I normally take it when I wake up, and I don't ever drink until the evening meal).
Having lived with epilepsy for ovr 30 years so far, I have come to see what elements of my lifestyle do affect the pattern, types, and frequency of my seizures. Right at the top of that list are (1) coffee, (2) lack of sleep, and (3) missing meals. I know that the caffeine issue has become quite a debate, not for just we "E" people, but for society as a whole. How much is "good" for us, and when does that extra cup become more than fun? But when working full-time, I'd often take in upwards to 10 cups per day. And the seizures were more intense and happening frequently. But was it the work or the "waker-upper" I'd so much enjoy? I'm now down to about 2 cups per day, and find that headaches are virtually gone. That my sleep feels oh-so-natural. And that my seizures are less frequent, and far lighter. I guess the side effects of any food or drink we may use depends on the person's unique body. Any of you notice that caffeine bothers your neuro system? I'm interested in hearing.
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
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
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.
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.
I have had TLE for 15 years now, I have just started wondering what I can do other than just take my AED's. The reason I visited the site was because caffeine seems to make me feel out of it. I always thought that this was the caffeine hit that everybody else was on about. However the experience of late has been horrible. I sometimes don't know what is going on, followed by severe headaches. These episode leave me feeling exhausted pretty much for the whole day. I am onto the green tea at the moment and it seems to be helping, however the craving for a fresh cup of coffee is still there.
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"
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
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?
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!
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 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.
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 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'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 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.
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.
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.