A recent study published in Neurology suggests that people with type 2 diabetes who use glucose-lowering GLP-1 drugs may have a lower risk of developing epilepsy compared to those using another class of diabetes medications. The research was led by Edy Kornelius, MD, PhD, from Chung Shan Medical University in Taichung, Taiwan.
The study analyzed data from a U.S. health database involving 452,766 adults with type 2 diabetes who began treatment with either GLP-1 receptor agonists—specifically dulaglutide, liraglutide, and semaglutide—or dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors). None of the participants had previously been diagnosed with epilepsy or seizures. Participants had an average age of 61 and were followed for at least five years.
During the follow-up period, 2.35% of those taking GLP-1 drugs developed epilepsy, compared to 2.41% among those on DPP-4 inhibitors. After adjusting for factors such as age, high blood pressure, and cardiovascular disease, researchers found that GLP-1 drug users were 16% less likely to develop epilepsy than those using DPP-4 inhibitors. The strongest association was observed with the drug semaglutide.
Kornelius emphasized that the findings are preliminary and do not establish a direct cause-and-effect relationship between GLP-1 drugs and reduced epilepsy risk. "Additional randomized, controlled trials that follow people over time are needed to confirm these findings, but these results are promising, since people with diabetes are at increased risk for developing epilepsy later in life," Kornelius said. "Epilepsy can have many physical, psychological and social consequences, and many people do not respond to the current medications, so finding ways to reduce this risk is critical."
He also noted: "More research is needed, but these findings support the theory that GLP-1 drugs may have neurological benefits beyond controlling blood sugar. It should be noted that these findings do not imply that DPP-4 inhibitors are harmful in any way or that GLP-1 drugs are definitely beneficial for brain health."
The study did not include tirzepatide—a dual GLP-1 and GIP receptor agonist—since it became available after the study period began; therefore, results may not apply to this medication.
Researchers acknowledged several limitations of their retrospective observational design. They lacked data on factors like family history of epilepsy or alcohol use and recognized that other variables such as medication cost or severity of diabetes could have influenced which drug patients received.
The research received support from Chung Shan Medical University Hospital.
