Alcohol and epilepsy

Does drinking alcohol cause epilepsy?

Research suggests that drinking large amounts of alcohol over a long time may increase your risk of developing epilepsy. This research showed that the more alcohol people drank, the higher the risk. Researchers do not know how much alcohol a person would need to drink to develop epilepsy.

Alcohol also increases the risk of head injury because of falls or accidents. Alcohol can also raise blood pressure, which increases the risk of stroke. Serious head injuries and strokes can cause epilepsy.

This does not mean that developing epilepsy is anyone’s fault. Epilepsy is a brain condition with many possible causes. It is not caused by one thing, such as alcohol. The exact cause is not known for many people.

Can I drink alcohol if I have epilepsy?

Drinking alcohol is a personal choice.

Some research studies have shown that modest social drinking is safe in most people with well-controlled epilepsy.

But alcohol is a common seizure trigger for people with epilepsy. Alcohol is often not the only seizure trigger. It can act together with other things, such as not getting enough sleep and stress.

Alcohol affects everyone in different ways. This is because of several things such as your age, social circumstances and health. For example, our bodies change as we get older. As we lose muscle and gain fat, alcohol is broken down more slowly and the liver cannot process alcohol as well. This can make you even more sensitive to alcohol.

It is important to understand how alcohol affects you.

Your healthcare professional can help you. Try to be honest with them about how much alcohol you drink. They are there to help you manage your epilepsy as well as possible, not judge you.

Find out more about things to talk about with your healthcare professional.

NHS guidance on drinking alcohol

Generally, the less you drink, the lower the health risks.

NHS recommends all adults to drink no more than 14 units a week on a regular basis. This should be spread out over 3 or more days to avoid binge drinking.

Less than 14 units of alcohol a week is considered ‘low-risk’ drinking rather than ‘safe’, because there is no safe drinking level.

NHS has more information on units of alcohol in drinks.

Epilepsy and binge drinking

Binge drinking is drinking heavily in a short space of time. Research suggests that binge drinking increases the risk of:

• Losing self-control
• Making unsafe decisions
• Accidents

Drinking a lot of alcohol quickly can increase the risk of epileptic seizures. This risk increases more as the amount of alcohol increases.

Binge drinking can also cause blackouts. These are gaps in your memory. This may it harder to remember if you have taken your epilepsy medicine.

It’s important to take your epilepsy medicine at the times prescribed by your doctor. Missing a dose can increase the risk of having a seizure.

What are the guidelines on how much I should drink?

Everyone is different, so how much someone with epilepsy can safely drink varies from person to person. There are no official guidelines about drinking alcohol for people with epilepsy. But if you do choose to drink, you might decide to follow the NHS guidelines about low risk drinking for everyone. These say that adults should drink no more than 14 units of alcohol a week.

More information on healthy drinking habits and alcohol units can be found on the Drinkaware website.

Will alcohol affect how well my epilepsy medicine works?

Yes. Alcohol may affect how your epilepsy medicines work.

Epilepsy medicines can make you relaxed, drowsy or sleepy. Drinking alcohol can do the same thing, so mixing them together can make these side effects worse.

This can be dangerous in some cases. For example, you should not drink alcohol while taking clonazepam. Drinking alcohol while taking clonazepam can make you go into a very deep sleep. There’s a risk you may not be able to breathe properly and you may have difficulty waking up.

Because alcohol and some epilepsy medicines can make you drowsy and tired, you may also feel drunker much faster than other people.

To find out more about alcohol and the epilepsy medicine you are taking:

• Talk to your GP, epilepsy specialist, epilepsy specialist nurse or pharmacist
• Check the patient information leaflet that comes with your medicine
• Look for your medicine leaflet on the electronic medicines compendium website

Drinking large amounts of alcohol regularly over a long period can reduce the amount of epilepsy medicine in the body. This can increase the risk of seizures.

Drinking a lot of alcohol can make you feel or be sick. Stomach problems like feeling or being sick can reduce how well the body absorbs medicines. This can increase the risk of seizures.

Feeling sick and being sick are also side effects of some epilepsy medicines. So alcohol can make these side effects worse.

Epilepsy, alcohol and lack of sleep

Alcohol can stop you getting a good night’s sleep.

REM sleep is an important stage of sleep. It helps the brain deal with emotions, remember things, and support healthy thinking and learning.

Research shows that even small amounts of alcohol (2 standard drinks) can reduce REM sleep.

Drinking a large amount of alcohol before bed may help you fall asleep faster and reach deep sleep sooner. But the short-term benefit is usually outweighed by poorer sleep quality.

A lack of sleep can trigger epileptic seizures.

Epilepsy, alcohol and your mental health

Some people enjoy having an alcoholic drink from time to time. It helps them relax and enjoy occasions such as having a drink with dinner or while out with friends.

But alcohol can become a problem for some people. Some people drink alcohol because they feel low, depressed or anxious. But drinking too much alcohol can cause anxiety and depression.

Research has found strong links between regular drinking at high-risk levels and self-harming, including suicide.

A hangover happens when you drink too much alcohol at one time then stop. The level of alcohol in your body decreases and you get dehydrated.

Hangovers can also make you feel low or depressed. You may also have alcohol-induced anxiety.

People with epilepsy have a higher risk of mental health issues for many reasons. Living with the condition can be stressful. Try to be mindful of how much alcohol you drink so it doesn’t add to this strain.

There is mental health support available if you need it.

We are also here for you.

Epilepsy, alcohol and the risk of SUDEP

SUDEP is the sudden unexpected death of someone with epilepsy.

No one knows the exact cause of SUDEP and there may be no single explanation. But there are some things that may increase your risk. This includes alcohol because:

• It can increase your risk of seizures
• You may be less likely to take your epilepsy medicine the way your doctor told you to
• It can disrupt your sleep
• It can affect your heart rhythm and breathing

Everybody’s risk of SUDEP is different and there are things you can do to reduce the risk. Find out more about SUDEP.

Tips for drinking alcohol safely

If you have epilepsy and want to drink alcohol:

• Check that you can drink alcohol with the epilepsy medicine you are taking
• Talk to your healthcare professional about drinking alcohol
• Take your epilepsy medicine as prescribed
• Avoid heavy and binge drinking
• Try to drink slowly
• Drink alcohol with food
• Alternate with water or non-alcoholic drinks. There are lots of alcohol–free spirits, beers, wines and mocktails now available
• Avoid drinking when sleep-deprived or unwell

Alcohol-use disorder

If you depend on alcohol you may get withdrawal symptoms when you stop or cut down. NHS says these include:

• Anxiety
• Difficulty sleeping
• Feeling and being sick
• A racing heartbeat, sweating and shaking
• Seeing, hearing or feeling things that are not there (hallucinations)
• Confusion

Alcohol withdrawal and seizures

Some people in alcohol withdrawal have seizures because of the rapid fall in blood alcohol concentration. This happens usually within roughly 6 to 17 hours after stopping drinking.

Alcohol withdrawal after drinking too much can be a trigger for status epilepticus. Status epilepticus is seizure that lasts 5 minutes or longer, or recurrent seizures without recovery in between. This is a medical emergency.

Find out more about status epilepticus.

Check your drinking

It can be helpful to think about what your relationship is like. DrinkAware have an online Drinking Check that you can use to find out more about your drinking habits.

Where can I get help and advice about drinking alcohol?

Some people find it difficult to control how much they drink. But you do not have to try and manage this alone. There are people who understand what you’re going through and can support you without judging you.

Professional help can include:

• Your GP, epilepsy specialist or nurse
• Local alcohol addiction support services
• Self-help or mutual aid groups, such as Alcoholics Anonymous
• Charities such as Drinkaware, Alcohol Change UK and The Wales Drug & Alcohol Helpline (free and bilingual telephone helpline)
• YoungMinds has information specifically for young people about drugs and alcohol

NHS has more information about alcohol support.

If you are worried about someone else’s drinking

You may be worried about someone else’s drinking if they have epilepsy. This is understandable, and support is available. Drinkaware also has information for people who are concerned about someone else’s drinking.

Someone you care about’s drinking can affect your own mental health and everyday life too. It’s important to prioritise your own mental health and wellbeing and make sure you have support too.

We are here for anyone affected by epilepsy. We offer a vital range of support services for you and your family. Connect through our helpline, join a support group, or benefit from one-to-one peer support. We are here to listen, advise, and empower you every step of the way.