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Seizure Medicines and Alcohol: Do They Mix?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on July 12, 2024.

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.

Benzodiazepine use for seizures

You should NOT drink alcohol if you are taking a benzodiazepine.

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.

Types of Drug Interactions With Alcohol

Sources

Further information

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

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