a) Use of valproic acid with concomitant alcohol intake may lead to increased valproic acid levels and possible intoxication. Alternately, a study in patients with head injuries found that the clearance of unbound valproate was increased up to 14% in those with measurable alcohol levels on admission.
b) A study found some increase in valproic acid levels in non-drinking epileptics who drank 1-3 glasses of an alcoholic beverage twice weekly over 2 hours for 16 weeks. The study observed no increase in the frequency of tonic-clonic convulsions, partial complex seizures, or epileptic activity.
c) Both alcohol and carbamazepine are CNS depressants, thus the potential for enhancement of adverse/toxic effects of both drugs exists.
d) Alcohol may theoretically increase the risk of hepatotoxicity associated with valproic acid.
a,b) Besides enhancing the effects of valproic acid on the CNS, ethanol also slows its metabolism, increasing its elimination half-life. In one case report, the concomitant ingestion of ethanol and other drugs metabolized by CYP3A4 could have been responsible for prolongation of the half-life of valproic acid.
c) The exact mechanism of increased CNS depression is unknown, but it appears that the effects are mainly additive.
d) Both alcohol and valproic acid can cause hepatotoxicity.
a) These results can be hard to interpret due to the fact that valproate levels are known to fluctuate and are difficult to reproduce.
b) Epileptics should avoid heavy drinking but there is no reason to avoid alcohol in moderate social amounts.
c) While concomitant use may be tolerated, it is important to be aware of the potential for additive CNS depression and to monitor accordingly.
Valproic acid can cause sleepiness, dizziness and confusion. Alcohol can make this worse, and make it more dangerous to drive or do activities that require alertness and attention.
Binge drinking or drinking regularly while taking valproic acid could damage your liver.
Remember, 1 drink = 1 beer, 1 glass of wine or 1 shot of liquor.
If you are depressed, blue, or moody, alcohol is a 'downer' and will make you feel worse.
Valproic acid can be taken with small amounts of alcohol, once in a while. This means your usual dose of valproic acid and 1 or 2 drinks. Drinking a lot, or drinking often (like several days of the week or every day) could affect how valproic acid works.