Frankfurt, Germany—Does use of antiepileptic drugs (AEDs) increase the risk of dementia? A study in the Journal of Alzheimer’s Disease sought to answer that question.
AEDs, which allow up to 80% of patients to become seizure-free, have been linked in previous studies to increased dementia rates, according to German researchers. To determine whether a relationship exists, the study team focused on 101,150 individuals receiving treatment from more than 1,400 physicians in Germany.
“In recent years, it has been suggested that there is a bidirectional relationship between epilepsy and dementia,” explained lead investigator Professor Karel Kostev, PhD, from the IQVIA Epidemiology Team. “In view of this, the prescription of antiepileptic drugs might be an effective strategy to prevent cognitive decline and dementia in patients affected by epilepsy. However, some researchers have assumed that AEDs could affect cognition by inhibiting neurotransmission and suppressing neuronal excitability.”
This retrospective cohort study used data from the Disease Analyzer database and included patients older than age 60 years whose first dementia diagnosis was documented between January 2013 and December 2017.
Ultimately, the study included 50,575 patients with dementia and 50,575 controls without. Participants had a mean age of 81 years, and 61.5% of patients were women.
Researchers found no significant association between any use of AEDs and dementia risk (odds ratio [OR] = 0.99), or that duration of AED therapy had any effect on risk of dementia (OR = 1.00 per therapy year).
The only group of drugs associated with increased dementia risk was generic levetiracetam brands (OR = 1.70, P <.001), although no association was found for the original levetiracetam brand (OR = 0.84, P >.05).
“Overall, AED use was not significantly associated with dementia risk in patients followed by general practitioners and neuropsychiatrists in Germany between 2013 and 2017,” study authors conclude. “Nonetheless, the potential deleterious effects of levetiracetam generic brands on cognition deserve further investigation.”
“The major message of this study is an all-clear for epilepsy patients, who should not fear that their AED use will result in a higher risk of dementia,” pointed out first author Louis Jacob, PhD, of the University of Versailles Saint-Quentin-en-Yvelines in France. “However, it is possible that some of the newest generic brands of levetiracetam may have negative effects on cognitive function in older individuals with epilepsy, and these effects have not yet been investigated.”
The authors of the study caution that their study is subject to some limitations, since no data from special epilepsy centers or on epilepsy severity were available.
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AEDs, which allow up to 80% of patients to become seizure-free, have been linked in previous studies to increased dementia rates, according to German researchers. To determine whether a relationship exists, the study team focused on 101,150 individuals receiving treatment from more than 1,400 physicians in Germany.
“In recent years, it has been suggested that there is a bidirectional relationship between epilepsy and dementia,” explained lead investigator Professor Karel Kostev, PhD, from the IQVIA Epidemiology Team. “In view of this, the prescription of antiepileptic drugs might be an effective strategy to prevent cognitive decline and dementia in patients affected by epilepsy. However, some researchers have assumed that AEDs could affect cognition by inhibiting neurotransmission and suppressing neuronal excitability.”
This retrospective cohort study used data from the Disease Analyzer database and included patients older than age 60 years whose first dementia diagnosis was documented between January 2013 and December 2017.
Ultimately, the study included 50,575 patients with dementia and 50,575 controls without. Participants had a mean age of 81 years, and 61.5% of patients were women.
Researchers found no significant association between any use of AEDs and dementia risk (odds ratio [OR] = 0.99), or that duration of AED therapy had any effect on risk of dementia (OR = 1.00 per therapy year).
The only group of drugs associated with increased dementia risk was generic levetiracetam brands (OR = 1.70, P <.001), although no association was found for the original levetiracetam brand (OR = 0.84, P >.05).
“Overall, AED use was not significantly associated with dementia risk in patients followed by general practitioners and neuropsychiatrists in Germany between 2013 and 2017,” study authors conclude. “Nonetheless, the potential deleterious effects of levetiracetam generic brands on cognition deserve further investigation.”
“The major message of this study is an all-clear for epilepsy patients, who should not fear that their AED use will result in a higher risk of dementia,” pointed out first author Louis Jacob, PhD, of the University of Versailles Saint-Quentin-en-Yvelines in France. “However, it is possible that some of the newest generic brands of levetiracetam may have negative effects on cognitive function in older individuals with epilepsy, and these effects have not yet been investigated.”
The authors of the study caution that their study is subject to some limitations, since no data from special epilepsy centers or on epilepsy severity were available.
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