Epilepsy and alcohol: the influence of social alcohol intake on seizures and treatment in epilepsy.

People suffering from epileptic seizures are often confronted with restrictions resulting from their attacks, such as exclusion from several professions and from some sports, not being allowed to drive a car, and prohibition of alcohol. Consultation of manuals to trace the literature studies on which this last prohibition was based was unsuccessful since there was no mention of the original research from which it appeared that alcohol was provocative of seizures. To be able to give a well-founded judgment on the influence of social alcohol intake on epilepsy, research was undertaken with epileptic patients who had never before or very sporadically used alcohol. During 16 weeks, twice a week, in a clinical setting, 1-3 glasses of an alcoholic beverage were consumed within a period of 2 h. The examination could be carried out double-blind since the drink that was chosen, vodka, is odorless and cannot be tasted when mixed with orangeade. We concluded the following. (a) No influence of social alcohol use on tonic-clonic convulsions or partial complex seizures is demonstrable. (b) Blood levels of carbamazepine, phenobarbital, and phenytoin are not influenced by alcohol intake. The valproic acid concentration is possibly slightly increased. However, this needs further examination before judgment can be made. (c) Both in frequency bands and in the amount of epileptic activity, no change is produced by alcohol use.