Seizures During Detox: Risk Factors and Prevention

Seizures are a withdrawal symptom that can occur during substance use detox, particularly alcohol detox. Alcohol withdrawal can be very dangerous, with certain risk factors contributing to the severity of symptoms. That’s why it’s highly recommended that you attend an inpatient medically supervised detox program if you are stopping alcohol use.

What Happens When You Stop Drinking

If you have been abusing alcohol for a period of time, your brain pathways have become altered, making your brain and body expect alcohol. When you stop drinking, your body begins to react to the lack of alcohol, producing withdrawal symptoms. Symptoms intensify over the first few days and last until your body adjusts to the lack of alcohol. The longer you have been drinking and the larger quantity you’ve been drinking, the worse the withdrawal symptoms will be.

Alcohol Withdrawal Symptoms and Timeline

Alcohol withdrawal is different for everyone, but certain symptoms are common and follow a general timeline.

Within 24 Hours

• Shaking
• Increased heart rate
• Sweating
• Nausea or vomiting
• Irritability

Days 2 to 4

• Insomnia
• Restlessness
• Agitation
• Nausea
• High blood pressure
• Cold sweats
• Hallucinations
• Seizures

Days 5 to 7

• Symptoms begin to subside
• Anxiety and depression may set in
• Insomnia may continue

The most dangerous effect of alcohol withdrawal is delirium tremens (DTs), which most often happen around day three, but can occur at any time during detox. Symptoms of the DTs include:

• Sudden confusion
• Uncontrollable tremors
• Paranoia
• Hallucinations
• High anxiety
• Fever
• High blood pressure
• A sense of the “creepy crawlies” on the skin
• Heart failure

About 15% of those who experience delirium tremens do not survive. If you have any of these symptoms during withdrawal, seek immediate medical care.

What Causes Seizures During Alcohol Withdrawal

Alcohol withdrawal seizures happen because long-term heavy drinking changes how the brain controls activity and balance. Alcohol slows the brain down, so over time the brain adapts by becoming more “revved up” to compensate. When someone suddenly stops drinking, that calming effect is removed all at once, leaving the brain in an overexcited state. This sudden surge in brain activity can overwhelm the nervous system and trigger seizures, especially within the first six to 48 hours after the last drink.

Risk Factors for Alcohol Withdrawal Seizures

Several factors can increase the risk of having alcohol withdrawal seizures, including:

• Drinking heavily for a long period of time
• History of withdrawal symptoms during detox
• Having other health issues, particularly liver or neurological issues
• Withdrawing from other substances at the same time
• Older age

Additionally, there is a phenomenon called the Kindling Effect, which occurs in people who detox multiple times. Each time they go through withdrawal, symptoms get progressively worse, making them more likely to experience seizures.

Preventing Alcohol Withdrawal Seizures

If you are going to stop drinking after prolonged use, it’s highly recommended that you attend an inpatient, medically supervised detox program. In detox, to prevent seizures, you’ll likely be given benzodiazepines like Ativan or Valium. You may also be given other medications to ease the withdrawal symptoms.

In detox you’ll be closely monitored by medical professionals to detect signs of serious withdrawal effects early so that medical intervention can occur. If you experience seizures or signs of the DTs, you’ll be taken to the hospital where you can be properly treated.

While stopping drinking on your own is not recommended because of the dangers, if you do so, it’s best to taper off alcohol slowly, reducing your consumption every day for a period of time before you stop completely. This may help to prevent seizures and serious withdrawal symptoms. However, it cannot be stressed enough how dangerous withdrawing on your own can be.

Treatment for Alcohol Addiction

Inpatient detox, while necessary, does not treat the addiction itself. You need treatment that involves intensive therapy.  There are generally three treatment programs options.

Inpatient Treatment

A 30 to 90 day inpatient treatment program includes a period of detox, but also includes intensive therapy, both individual and in groups. You may also be treated for any co-occurring disorders that you may have, such as anxiety and depression.

Inpatient treatment is intensive, with most of your time usually spent in group or individual therapy. Group therapy is critical to the treatment process, giving you the opportunity to learn more about the nature of addiction, and to share emotions, experiences, and challenges with peers.  You’ll likely form mutually supportive relationships with some of these peers which may last beyond treatment.

The type of therapy most commonly used in alcohol addiction treatment is cognitive behavioral therapy (CBT). CBT teaches you to recognize your irrational thoughts and negative emotions and to challenge them using more realistic, positive thinking. It also teaches healthy coping skills to help you face challenges without alcohol.

Partial Hospitalization Programs (PHPs)

A partial hospitalization program (PHP) allows you to live at home while attending treatment for four to six hours per day, usually five days a week. The program may last anywhere from four weeks to ten weeks. The treatment consists of therapy similar to that of inpatient treatment, both in groups and individually.

More often than not, a PHP program is a transitional step that occurs after a detox program or inpatient treatment, although it can be an alternative to inpatient treatment.

Intensive Outpatient Programs (IOPs)

An intensive outpatient program (IOP) consists of two to three hours of therapy several days a week for eight to twelve weeks. Often, sessions are held in the evenings so that you can still go to work or attend school. Treatment, again, involves individual and group cognitive behavioral therapy.

IOPs can be standalone treatments, or they can be attended after inpatient treatment, PHPs, or both.

Comprehensive Treatment

The most effective treatment for alcohol addiction is a comprehensive treatment program that consists of an inpatient program, a PHP, and an IOP. Research shows that success rates increase the longer the treatment program. Even after IOP, support should continue through support groups, individual therapy, or both. Recovery from alcohol addiction, or any addiction, is a lifelong process that requires dedication and a strong support network.

In Closing

Alcohol withdrawal can be extremely dangerous, coming with a risk of seizures and delirium tremens, which is life threatening. Medically supervised detox can help you to avoid these serious complications. At Bridges of Hope, we offer a medically supervised detox program as well as comprehensive addiction treatment options. We are committed to providing personalized, compassionate care to help you transition into a better, healthier, life. Give us a call today to learn more.