Epilepsy CurrentsAnti-Seizure Medications on Trial Again: Accused of Parkinson’s Disease!

Could long-term exposure to antiepileptic drugs be a previously uncharted pathway to Parkinson’s disease?

The correlation between epilepsy and Parkinson’s disease (PD) has been in focus recently, and the role of antiepileptic drugs (AEDs) in increasing the incidence of PD has been highlighted. A nested case-control study explores this relationship further, delivering insights with significant implications for the medical community.

Key Points:

• The study used data from the UK Biobank (UKB), specifically targeting individuals with linked primary care prescription data, with controls matched 6:1 for various variables.
• Out of 1,433 individuals with a PD diagnosis, 873 were male, and the majority (97.5%) identified as White; their median age was 71.
• An association was found between AED prescriptions (specifically carbamazepine, lamotrigine, levetiracetam, and sodium valproate) and incident PD (odds ratio, 1.80; 95% CI, 1.35-2.40).

Additional Points:

• A trend was noted for a greater risk of PD with an increased number of prescription issues and use of multiple AEDs.
• It’s the first study to systematically explore PD risk in individuals prescribed common AEDs.

Commentary Key Points:

• Concerns about the long-term side effects of anti-seizure medications (ASMs) are being raised.
• The commentary highlights the limitations of the study’s methodology, including the small size of the exposure group and the accuracy of diagnostic codes.

Commentary Additional Points:

• The association between lamotrigine, levetiracetam, and valproic acid and PD was deemed robust, especially for valproic acid.
• However, the association between levetiracetam, lamotrigine, and PD was deemed unexpected.

Conclusion:

Although this study reveals an association between AEDs and incident PD, more rigorous studies are needed, given the limitations noted in the commentary, to further understand this correlation.

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