Link Between Epilepsy Drugs and Increased Risk of Dementia Interview with:
Britta Haenisch, PhD

Pharmacoepidemiology in Neurodegenerative Disorders
German Center for Neurodegenerative Diseases,
DZNE What is the background for this study? What are the main findings?

Response: Antiepileptic drugs (AEDs) have been shown to affect cognition by suppressing neuronal excitability and increasing inhibitory neurotransmission. Previous studies suggested that AEDs may be associated with cognitive adverse effects. Therefore, we evaluated the association between AED use and incident dementia and Alzheimer’s disease (AD).

We utilized large longitudinal datasets from Finnish health registers and from German health insurance data. The case-control analyses was adjusted for several potential confounders like comorbidities and polypharmacy. The inclusion of a lag time between . Antiepileptic drugs use and dementia diagnosis allowed minimization of protopathic bias.

Our study provides an association between regular prescription of  antiepileptic drugs with known cognitive adverse effects and the occurrence of dementia and AD in patients aged 65 years and older. What should readers take away from your report?

Response: Our study is the first study on the association of .antiepileptic drugs use and dementia risk based on large longitudinal insurance and health register data. Comparable results were observed in the Finnish and German datasets. The results have to be confirmed in further studies. Clinicians always should weigh up the benefits of drugs against potential side effects. This holds true especially for drugs with relatively narrow therapeutic indices that are prescribed to older patients where age-related changes may increase the risk for adverse drug events. What recommendations do you have for future research as a result of this work?

Response: The study can only provide a statistical association, it does not prove that antiepileptic drugs with cognitive adverse effects cause dementia. To evaluate cause and effect relationships between long-term AED use and possible effects on cognition and dementia, large randomized, prospective clinical studies are needed. Is there anything else you would like to add? 

Response: We are grateful to the Scientific Research Institute of the AOK (WIdO) and Finnish health care registers for providing the data. 


Heidi Taipale, Willy Gomm, Karl Broich, Wolfgang Maier, Anna-Maija Tolppanen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Britta Haenisch. Use of Antiepileptic Drugs and Dementia Risk-an Analysis of Finnish Health Register and German Health Insurance Data. Journal of the American Geriatrics Society, 2018; DOI: 1111/jgs.15358 

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Last Updated on April 12, 2018 by Marie Benz MD FAAD