If you have alcohol use disorder and want to stop drinking, talk to a healthcare provider. They can help you find resources, care and support that’ll help you reduce alcohol intake safely, and also give you the best chance at a positive outcome. They can recommend alcohol rehabilitation programs, specialist providers, support groups and more. Alcohol withdrawal may increase risk of sudden death because it may prolong QT interval, the reason why EKG should be performed in patients presenting with alcohol withdrawal seizures or alcohol-related seizures (34). Symptoms outside of the anticipated withdrawal period or resumption of alcohol use also warrants referral to an addiction specialist or inpatient treatment program. When people binge drink (consume a large amount of alcohol in a short period of time), the subsequent alcohol withdrawal can trigger seizures.
Mixing Alcohol and Epilepsy Drugs
Symptom-triggered treatment has been reported to be as effective as fixed-dose or loading therapy, resulting in lower doses and shorter treatment time (58). Yet, treatment strategies and doses vary from center to center and consensus is lacking (46). Because alcohol withdrawal seizures are a symptom of severe acute withdrawal syndrome, they should be treated as such. Patients should be admitted and close monitoring should be available, assessing the patient every 1 to 2 hours for up to 6 alcohol withdrawal seizure to 24 hours (79). As mentioned above, the revised CIWA-Ar scale can be applied to grade the severity of alcohol withdrawal (71).
Support for AUD
Phenytoin does not have evidence of effectiveness at preventing alcohol withdrawal seizures in the ED. The first consideration in a patient with possible alcohol withdrawal seizures is the exclusion of life-threatening causes of seizures, as described in the differential diagnoses above (42). At the same time, a history of chronic alcohol abuse must be sought and the patient should be classified as having one of the categories of alcohol-related seizures (42). As more than 90% of alcohol withdrawal seizures occur soon after the cessation of sustained drinking, whereas other withdrawal symptoms develop gradually, withdrawal may not be readily evident in the beginning (27). Developing a tolerance for alcohol has a direct impact on the central nervous system.
- Establishing a health baseline and familiarizing providers with the patient’s medical history allows for more effective detection of new or unusual symptoms.
- This can be permanent, as alcohol can cause changes to the nerves themselves.
- Medications such as clonazepam and lorazepam are benzodiazepines that can cause a life threatening interaction when mixed with alcohol.
- However, no clear evidence supports the use of one type of benzodiazepine over others.
- Withdrawal is something that happens when your body has become dependent on the presence of drugs or alcohol.
Online Therapy Can Help
It is crucial to distinguish alcohol-related seizures from other medical conditions, such as alcohol poisoning, which can also lead to seizures due to metabolic disturbances. Individuals with a history of alcohol misuse presenting with these symptoms should be evaluated for alcohol withdrawal seizures, especially if they occur within 6 to 48 hours after the last drink. A primary mental health disorder should not be diagnosed during the acute withdrawal period, as signs and symptoms may overlap (anxiety, sleeping disturbance, agitation) (79). However, screening questionnaires such as the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) may help orient a diagnosis when feasible and are recommended in the guidelines (79).
For people AFAB, that means drinking two or more drinks per day and eight or more drinks per week. However, DTs becomes more and more likely the more you drink and the longer this continues. If you have delirium tremens, confusion is one of the key symptoms you’ll experience. It’s also possible that you’ll experience hallucinations, meaning you’ll see or hear things that seem real to you, but that aren’t really there. The main symptoms of DTs often take between three to seven days to go away. In severe cases, you may experience some symptoms for weeks to months.
- Despite a shorter half-life it has longer duration of action because it is distribution is slower and less extensive (13).
- Among the seven RCTs, one was at high risk of bias, two had some concerns, and the remainder was at low risk.
- Even if you’re not a chronic drinker, in some cases, you may also experience withdrawal seizures after binge drinking.
- Seeking treatment at a professional alcohol rehabilitation facility can help you significantly reduce or stop your drinking.
- If people have an alcohol use disorder, they can talk with a healthcare professional about treatment options.
Results of individual studies
Treating alcohol seizures involves a multifaceted approach that addresses immediate medical needs and the underlying alcohol use disorder (AUD). The primary treatment includes administering benzodiazepines, which are effective for managing acute withdrawal symptoms and preventing further seizures. These seizures are primarily generalized tonic-clonic seizures and can be single episodes or occur in a series. There are no well-documented cases where an alcohol seizure was established as the cause of death in a person with a history of long-term alcohol abuse. However, severe alcohol withdrawal syndrome can be life-threatening due to complications such as seizures and delirium tremens (DTs).
As the current intoxication level is important information with potential treatment consequences, blood alcohol concentration should be measured in patients with suspected alcohol-related seizures (64). Urinary ethyl glucuronide and ethyl sulfate have been reported to have high sensitivity and specificity for recent drinking (11; 70). For detection of alcohol overuse, questionnaire-based interviews are reported to be more sensitive than any biomarker (04). However, in cases where information on recent alcohol consumption is unavailable or considered unreliable, markers of alcohol consumption can increase accuracy of clinical diagnosis (06; 08). Carbohydrate-deficient transferrin (CDT) and gammaglutamyl transferase (GGT) are sensitive markers for alcohol overuse; systematic literature reviews have been inconclusive as to which marker is better (59; 68). No biomarker can be recommended for screening of unselected seizure populations (06; 08).
• A history of epilepsy prior to alcohol abuse is suggestive of seizures triggered by alcohol abuse instead of alcohol withdrawal seizures and management may vary accordingly. Those with epilepsy who have alcohol dependence and stop drinking suddenly have an additional risk of withdrawal-induced seizures. Binge drinking can cause alcohol withdrawal seizures in people, even for individuals who do not have epilepsy. Fortunately, no matter how severe the drinking problem, most people with an alcohol use disorder can benefit from treatment.