Can Caffeine Trigger Seizures? The Truth for People with Epilepsy

Caffeine is the world’s most commonly used central nervous system stimulant. For people with epilepsy, it’s not always clear whether caffeine can increase seizure risk.

🧠 How caffeine works:

Caffeine blocks adenosine receptors in the brain. Adenosine is what makes you feel tired and less alert. By blocking it, caffeine reduces tiredness signals and makes you feel more awake. Simple!

☕ What caffeine may help with

‘Normal’ caffeine intake may improve:
• Alertness
• Attention
• Focus
• Physical endurance

⚡Caffeine & Epilepsy

However, when it comes to epilepsy, we have to take certain precautions as the evidence is mixed. A 2018 study found that while long-term caffeine use may reduce seizure risk in some cases, preclinical research suggests it could also increase seizure susceptibility.

🔬 Caffeine and seizures: A systematic review and quantitative analysis - ScienceDirect

Another study found that overall coffee intake didn’t affect general seizure frequency. However, it did show a possible link with a specific seizure type called focal to bilateral tonic-clonic seizures (FBTCS).

Moderate coffee drinkers had fewer of these seizures compared with others:

• Non–coffee drinkers were ~1.6× more likely to have at least one FBTCS per year
• Rare drinkers showed a similar increased risk
• High coffee intake was linked to about double the risk

When analysed further, the trend suggested a possible association, but the evidence wasn’t strong enough to draw firm conclusions.

🔬 Coffee consumption and seizure frequency in patients with drug-resistant focal epilepsy - ScienceDirect

However, what is clear is that caffeine does have an impact on anticonvulsant medication. A 2023 study found that high caffeine intake may significantly increase seizure frequency and reduce quality of life in people with epilepsy as it interacts with medication control.

Some anti-seizure medications particularly affected are:
• Carbamazepine
• Phenobarbital
• Phenytoin
• Valproate
• Gabapentin
• Levetiracetam
• Pregabalin
• Topiramate

🔬 Caffeine and Its Interactions with Antiseizure Medications—Is There a Correlation between Preclinical and Clinical Data? - PMC

✏️Conclusion

Caffeine may make epilepsy harder to manage. It can reduce the effectiveness of anti-epileptic drugs, potentially increasing seizure risk. This may be due to caffeine’s effects on the brain and body, and in some cases, it may also affect how certain medications (such as carbamazepine) are processed. For this reason, people with epilepsy are often advised to limit or avoid high-caffeine drinks.

⚠️ Other Possible Nervous System Effects

→ Research suggests regular coffee drinkers show different brain connectivity patterns compared with non-drinkers. Some networks appear less strongly connected, including:
• Somatosensory regions (movement, touch, alertness)
• Limbic system (emotion, memory, motivation)

Other affected areas include:
• Cerebellum (coordination, sensory processing)
• Thalamus (information relay)
• Striatum (movement and reward)

Overall, brain networks may become more “segregated,” which could reflect more efficient processing, though the meaning of this is still unclear.

→ Stress and anxiety
• Coffee drinkers reported higher stress levels
• More difficulty relaxing and increased nervousness
• Some signs of increased muscle activation, possibly linked to alertness

→ Other findings (energy drinks)
Students who frequently consumed energy drinks were more likely to:
• Have lower school attendance
• Receive behavioural sanctions
• Achieve lower grades

These associations remained even after adjusting for factors like income and special educational needs.

🔬 Habitual coffee drinkers display a distinct pattern of brain functional connectivity | Molecular Psychiatry
🔬 Caffeine Effects on the Central Nervous System and Behavioral Effects Associated with Caffeine Consumption - Caffeine in Food and Dietary Supplements: Examining Safety - NCBI Bookshelf

☕ Drinks With The Most Caffeine

1. Coffee
   • ~90 mg per 200 ml brewed cup - (0.45 mg/ml)
   • ~80 mg per 60 ml espresso shot - (1.33 mg/ml)

2. Energy drinks
   • ~80 mg per 250 ml (varies by brand) - (0.32 mg/ml)

3. Cola
   • ~37 mg per 355 ml can - (0.10 mg/ml)

4. Tea
   • Black tea: ~28 mg per 250 ml - (0.11 mg/ml)
   • Green tea: ~19 mg per 250 ml - (0.08 mg/ml)

5. Chocolate (raw cacao)
   • ~12 mg per tablespoon of powder - (1.5–2 mg/ml (estimated))

SOURE: Caffeine levels in different foods and drinks | Eufic

⬇️ Low Or No Caffeine Alternatives

COFFEE ALTERNATIVES

1. Decaffeinated coffee
   • Still contains a small amount of caffeine (~4 mg per 200 ml cup)

2. Chicory coffee
   • Caffeine-free alternative made from chicory root
   • Contains inulin, a prebiotic that may support gut health
   • Also provides nutrients like manganese and vitamin B6

HERBAL TEAS

Most herbal teas are naturally caffeine-free. Options include:
• Chamomile
• Passionflower
• Lemon balm

*Infographic on Herbal: Teas That Calm The Epileptic Mind

COLA ALTERNATIVES

For a caffeine-free, lower-sugar option, try:
• Homemade fruit-infused sparkling water (e.g. fruit tea + sparkling water + lemon). You can add optional natural sweeteners like honey or maple syrup.
• Some ready-made drinks (e.g. kombucha varieties) may also be low in caffeine. I like Zak’s Lavender Kombucha which is almost caffeine free and made with natural ingredients and no artificial sweeteners.

RAW CACAO

Cacao is low in caffeine and rich in beneficial plant compounds (flavonoids) that may:

• Improve blood flow to the brain

• Support memory and learning

• Help protect brain cells

• Possibly reduce age-related cognitive decline and risk of neurological disease

*However, the exact amount needed for these benefits is still not fully known.

🌿Overall Conclusion

There’s no need to completely avoid caffeine, but it’s important to be mindful of how much you consume and in what form. From my perspective, coffee contains high caffeine and offers limited additional brain benefits, while strongly stimulating the nervous system.

In contrast, drinks like…

• Raw cacao hot chocolate

• Green tea (rich in beneficial plant compounds)

• Kombucha (contains prebiotics)

…may provide more balanced benefits, making their caffeine content more acceptable.

Book a discovery call with me to learn more on how to manage epilepsy through diet, lifestyle, and mindset.