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Seizure / Epilepsy Medications and Alcohol

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 22, 2019.

Many medications used to treat seizures (anticonvulsants) can have drug interactions with alcohol (ethanol). Most commonly, added central nervous system side effects like drowsiness, dizziness, mood changes, and trouble concentrating, can occur.  

You should avoid drinking alcohol when you are taking seizure medications for epilepsy until you've discussed this with your doctor. Some medications have warnings against any alcohol use. Stay away from hazardous activities requiring mental alertness and good reflexes, such as driving. If drinking worsens your seizures, you should avoid alcohol completely.

Excessive alcohol use can lead to abnormal electrical activity in the brain.

  • Binge drinking is having too much alcohol at once or over a longer period of time.
  • Having three or more alcoholic beverages or binge drinking may increase the risk of seizures or status epilepticus.
  • In someone with epilepsy, seizures from drinking too much alcohol may occur as long as three days after drinking has stopped. 

Alcohol withdrawal also lowers the seizure threshold, so don't suddenly stop drinking if you have been drinking excessively. Seizure activity due to withdrawal typically occurs in someone (with or without epilepsy) who has been drinking excessively over a long period of time. However, alcohol withdrawal may worsen your epilepsy.

Some medications are metabolized (broken down for excretion) through the liver. Alcohol use may change the blood levels of your seizure medication and lead to serious problems. 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. Discuss these interactions with your doctor or pharmacist if you have questions about the combined use of alcohol and your epilepsy medication. 

You should not drink alcohol during benzodiazepine therapy. Certain seizure medications such as clonazepam (Klonopin), lorazepam, and diazepam (Valium) are classified as benzodiazepines and can lead to serious central nervous system depressant interactions with alcohol. 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.

Table 1. Common Seizure Medications

*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions. Tell your healthcare providers about all the other medications you use, including prescription, over-the-counter (OTC) drugs, vitamins, dietary supplements and herbal products.

Types of Drug Interactions With Alcohol

Sources

  1. Gordon E. Devinsky O. Alcohol and Marijuana: Effects on Epilepsy and Use by Patients with Epilepsy. Epilepsia. 2001:1266-72. Accessed Nov. 21, 2019 at https://doi.org/10.1046/j.1528-1157.2001.19301.x
  2. 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
  3. Riss J, Cloyd J, Gates J et al. Benzodiazepines in epilepsy: pharmacology and pharmacokinetics. Acta Neurol Scand 2008: 118: 69–86. Accessed Nov. 23, 2019 at doi: 10.1111/j.1600-0404.2008.01004.x
  4. If You Have Epilepsy, Don’t Overdo Alcohol. Cleveland Clinic. Accessed Nov. 23, 2019 at https://health.clevelandclinic.org/moderation-key-in-mixing-alcohol-and-epilepsy/
  5. Limit Alcohol and Illicit Substances.Epilepsy Foundation. Accessed Nov. 23, 2019 at https://www.epilepsy.com/aimforzero/limit-alcohol-illicit-substances#fn1
  6. The Effects of Mixing Benzodiazepine and Alcohol. Alcohol.org. Accessed Nov. 23, 2019 at https://www.alcohol.org/mixing-with/benzodiazepine/
  7. Harmful Interactions. Mixing Alcohol With Medicines. National Institute on Alcohol Abuse and Alcoholism. Accessed Nov. 23, 2019 at https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.