Seizure Medicines and Alcohol: Do They Mix?
Medications used to treat seizures (called anticonvulsants) may have serious drug interactions with alcohol use. Side effects like drowsiness, dizziness, and confusion can occur. Driving or other activities may become hazardous. With some medicines, breathing may be slowed or stopped. Ask your doctor before you combine alcohol with an anticonvulsant.
Can I drink alcohol with seizure medications?
You should avoid drinking alcohol when you are taking seizure medications for epilepsy until you've discussed this with your doctor. Some medications, such as benzodiazepines and phenobarbital, have warnings against any alcohol use. Stay away from hazardous activities requiring mental alertness and good reflexes, such as driving, operating machinery or other hazardous activities.
If your doctor agrees that you can drink alcohol, ask how much you can safely drink and how often. If you choose to drink, always drink in moderation and only occasionally. It's best to have an alcoholic drink with a meal and not on an empty stomach. Heavy alcohol use is never recommended for people with epilepsy.
If drinking alcohol worsens your seizures, you should avoid alcohol completely. Excessive alcohol use can lead to abnormal electrical activity in the brain, worsen seizures and disrupt sleep, which may also trigger a seizure.
Alcohol use with your epilepsy medicines might provoke seizures if you misuse other substances, like marijuana or illicit drugs.
Drinking too much alcohol may also increase the risk of low blood sugar (hypoglycemia), forgetting to take your epilepsy medicine, or skipping a meal, which could also trigger a seizure.
Related: Check for drug interactions using the Drugs.com Interaction Checker
Alcohol may also change the way an extended-release medication (for example: Trokendi XR) is released into your bloodstream. This effect may change how well your drug works for seizures or increase your for side effects. Do not use Trokendi XR within 6 before or 6 hours after taking Trokendi XR.
Check with your pharmacist or doctor if you take long-acting, extended-release, sustained-release or controlled-release seizure medicines to see if there is a drug interaction with alcohol.
Do not stop using any medications without first talking to your doctor.
Binge drinking
Binge drinking is having too much alcohol at once or over a longer period of time. Having 3 or more alcoholic beverages or binge drinking may increase the risk of provoked seizures or status epilepticus.
In someone with epilepsy, drinking too much alcohol may lead to seizures as long as 3 days after drinking has stopped. However, one retrospective study using a questionnaire identified that almost all alcohol-related seizures (95%) occurred within the first 12 hours after stopping heavy alcohol intake.
Alcohol withdrawal
Alcohol withdrawal can lower the seizure threshold. Don't suddenly stop drinking if you have alcohol use disorder (alcoholism) or have been drinking excessively without talking to your doctor first.
Alcohol withdrawal may worsen your epilepsy. Seizure activity due to alcohol withdrawal typically occurs in someone (with or without epilepsy) who has been drinking excessively over a long period of time. The withdrawal seizures triggered by alcohol withdrawal are not due to epilepsy itself.
Liver disease
Drinking too much alcohol can also cause problems with your liver, like hepatitis, cirrhosis, liver cancer or alcoholic fatty liver disease.
- Many medications and alcohol are both metabolized (broken down for excretion) through the liver. Alcohol use or liver problems might change the blood levels of some seizure medications and lead to serious problems.
- Seizure drugs like valproic acid, phenytoin, and felbamate can be toxic to the liver.
- Tell your doctor if you have liver disease or drink alcohol before you start any treatment.
Benzodiazepine use for seizures
You should NOT drink alcohol if you are taking a benzodiazepine.
- Certain seizure medications such as clonazepam (Klonopin), lorazepam (Ativan), and diazepam (Valium) are classified as benzodiazepines and can lead to serious central nervous system (CNS) depressant interactions with alcohol. Drowsiness, dizziness or confusion may worsen.
- Your breathing or heart rate may be slowed. In addition, your memory may be affected.
- Benzodiazepines should also be used with extreme caution if you have history of alcohol or drug abuse.
Discuss these possible drug interactions with your doctor or pharmacist if you have questions about the combined use of alcohol and your epilepsy medication.
Free help is available to address excessive drinking. Call the SAMHSA National Helpline at 1-800-662-4357 for confidential information and discuss this issue with your healthcare provider.
Table 1. Common Seizure Medications
Generic Name | Common Brand Names |
---|---|
brivaracetam | Briviact |
cannabidiol | Epidiolex |
cenobamate | Xcopri |
carbamazepine | Equetro, Tegretol, Tegretol XR, Epitol |
clobazam | Onfi, Sympazan |
clonazepam | Klonopin |
diazepam | Valium, Valtoco, Diastat |
eslicarbazepine | Aptiom |
ethosuximide | Zarontin |
felbamate | Felbatol |
fosphenytoin | Cerebyx |
gabapentin | Neurontin |
lacosamide | Motpoly XR, Vimpat |
lamotrigine | Lamictal |
levetiracetam | Keppra, Roweepra, Spritam |
midazolam | Nayzilam spray |
oxcarbazepine | Trileptal, Oxtellar XR |
perampanel | Fycompa |
phenobarbital | Not available |
phenytoin | Dilantin, Phenytek |
pregabalin | Lyrica (Lyrica CR not approved for partial onset seizures) |
primidone | Mysoline |
rufinamide | Banzel |
stiripentol | Diacomit |
tiagabine | Gabitril |
topiramate | Topamax, Qudexy XR, Trokendi XR |
valproic acid | Depakene |
vigabatrin | Sabril |
zonisamide | Zonegran |
*Note: This is not a complete list of seizure medicines or possible interactions; always check with your pharmacist for possible drug-alcohol interactions. Tell your healthcare providers about all the medications you use, including prescription, over-the-counter (OTC) drugs, vitamins, and dietary and herbal supplements.
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Learn more
Treatment options
- Medications for Dravet Syndrome
- Medications for Epilepsy
- Medications for Lennox-Gastaut Syndrome
- Medications for Seizures
- Medications for Status Epilepticus
Care guides
- Epilepsy
- Epilepsy and Pregnancy
- Generalized Tonic Clonic Seizures
- Nonepileptic Seizures
- Status Epilepticus
Symptoms and treatments
Medicine.com guides (external)
Sources
- Hamerle M, Ghaeni L, Kowski A, et al. Alcohol Use and Alcohol-Related Seizures in Patients With Epilepsy. Front Neurol. 2018 Jun 5;9:401. doi: 10.3389/fneur.2018.00401.
- Schachter S (author). Patient education: Seizures in adults (Beyond the Basics). July 29, 2022. Up to Date. Accessed July 12, 2024 at https://www.uptodate.com/contents/seizures-in-adults-beyond-the-basics
- Gordon E. Devinsky O. Alcohol and Marijuana: Effects on Epilepsy and Use by Patients with Epilepsy. Epilepsia. 2001:1266-72. https://doi.org/10.1046/j.1528-1157.2001.19301.x
- Nichols JM, Martin F, Kirkby KC. A comparison of the effect of lorazepam on memory in heavy and low social drinkers. Psychopharmacology (Berl) 1993:112: 475-82.
- Kruithof A, Watanabe S, Peeters P, et al. Pharmacological interactions between brivaracetam and ethanol in healthy males. J Psychopharmacol. 2017 Jul;31(7):915-926. doi: 10.1177/0269881116665326
- Riss J, Cloyd J, Gates J et al. Benzodiazepines in epilepsy: pharmacology and pharmacokinetics. Acta Neurol Scand 2008: 118: 69–86. doi: 10.1111/j.1600-0404.2008.01004.x
- Limit Alcohol and Illicit Substances. Epilepsy Foundation. Nov. 2017. epilepsy.com/aimforzero/limit-alcohol-illicit-substances#fn1
- The Effects of Mixing Benzodiazepine and Alcohol. Alcohol.org. https://www.alcohol.org/mixing-with/benzodiazepine/
- Harmful Interactions. Mixing Alcohol With Medicines. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines
- Alcohol as a seizure trigger. Epilepsy Foundation. Accessed July 14, 2024 at https://www.epilepsy.com/what-is-epilepsy/seizure-triggers/alcohol#Facts-About-Alcohol-and-Seizures
Further information
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