Alcohol, drugs and epilepsy

Whether to drink alcohol or take recreational drugs is a personal choice, but it is worth knowing the possible effects they could have on your epilepsy. Alcohol or recreational drugs can cause epilepsy in some people.

Can I drink alcohol if I have epilepsy?

Drinking alcohol is a personal choice, and the effect of alcohol varies from one person to another. Some people find that they are OK to drink, while others find that it makes their seizures worse. Having epilepsy doesn’t necessarily mean you can’t have an alcoholic drink, but it is important to be careful with alcohol for the following reasons:

• Alcohol disrupts your sleep. Seizures can be triggered by tiredness for many people, so poor sleep makes seizures more likely to happen.
• Drinking alcohol can trigger seizures for some people; not always while they’re actually drinking. Often it’s later, during a hangover when the alcohol level in the body is falling, that seizures happen.
• Vomiting (being sick) may reduce the level of anti-seizure medication (ASM) in your system, so it may not work so well to control your seizures.
• ASM can increase the effects of alcohol and alcohol can make some of the side effects of ASM worse.

Drinking water in between alcoholic drinks can help reduce the chances of a hangover, but will not prevent seizures from occurring. The patient information leaflet that comes with your ASM should say if alcohol is not recommended. You could ask your doctor or pharmacist if you are not sure.

Alcohol misuse

Consuming large amounts of alcohol over a long period of time seems to be associated with a higher risk of developing epilepsy. Research has found that the risk of epilepsy increases as alcohol consumption increases. Alcohol withdrawal syndrome is a condition that occurs after someone suddenly stops drinking alcohol after drinking heavily. This condition may cause mild symptoms at first, such as headaches, anxiety, stomach pain and being unable to sleep properly. But it could go on to cause more serious symptoms such as epilepsy. Because of the risks of seizures and other symptoms, anyone with epilepsy who has been drinking heavily should seek medical support before stopping drinking alcohol. Sudden unexpected death in epilepsy (SUDEP) is rare and is when someone who has epilepsy dies suddenly and no other cause of death can be found. Research has found that the risk of SUDEP is twice as high for people with epilepsy who have a history of being dependent on alcohol. Visit the NHS and drinkaware websites for more advice and support.

Recreational drugs and epilepsy

Taking cannabis, ecstasy, speed, cocaine, and other recreational drugs can trigger, or increase the frequency of, seizures for some people. They can also interact with medication. Taking recreational drugs increases the risk of seizures and of mental and physical health problems, which in turn may make seizures more likely. Recreational drugs include illegal drugs and ‘legal highs’. Also, you can never be certain what exactly is in recreational drugs. Learning more about your own epilepsy and treatment means you can make informed choices about your lifestyle. Frank has more information about drugs.

Medical cannabis

Medical cannabis is a medicine used to treat a variety of symptoms. It is based on a part, or parts of the cannabis plant. The cannabis plant contains cannabidiol (CBD) and tetrahydrocannabinol (THC). Currently, Epidyolex is the only cannabis-based medicine approved for treating epilepsy in the UK. It contains pure CBD, which does not cause the changes in mood that THC can. It does not contain any THC. Epidyolex can only be prescribed as an add-on treatment for adults and children over the age of two with:

• Dravet syndrome;
• Lennox-Gastaut syndrome; and
• Tuberous sclerosis complex (TSC)

The National Institute for Health and Care Excellence (NICE) is the organisation that makes recommendations about what medicines doctors can prescribe on the NHS. NICE recommends that Epidyolex is only used to treat the conditions above if two other ASM have been tried and they have not controlled the seizures. They also recommend that doctors check every six months to see if Epidyolex is working to control or reduce seizures and stop prescribing it if it is not.

Some cannabis-based products are available to buy over the internet, without a prescription. It could be that most of these products may be illegal in the UK, even those called CBD oils. It’s possible that they may contain THC, and may not be safe to use.

Some health stores sell certain types of CBD. However, NHS information suggests that there’s no guarantee these products are of good quality, or that they give any health benefits.

If you do decide to use CBD it’s important to let your epilepsy specialist know as it might affect the way your existing ASM works.

You should never stop taking your prescribed ASM without talking to your specialist first as this could cause more seizures or more severe seizures. Visit the NHS website for more information.

Epilepsy Society is grateful to Dr F J Rugg-Gunn, Consultant Neurologist & Honorary Associate Professor, Clinical Lead, Chalfont Centre for Epilepsy, who reviewed this information.

Information updated: September 2024