Prolonged Use of Anti-Epileptic Drugs Can Increase the Risk of Dementia

Highlights

Continuous use of anti-epileptic drugs for more than a year has now been associated with an increased risk of Alzheimer's disease and dementia in older patients.
Some anti-epileptic drugs that are known to impair cognitive function, can increase the risk Alzheimer's disease by 20 percent and dementia risk by 60 percent.
Higher doses have also been associated increased risk of dementia and Alzheimer's disease.

Long-term use of the anti-epileptic drug has now been associated with increased risk of dementia and Alzheimer’s disease in older patients, finds a new study. The findings of this study are published in the Journal of the American Geriatrics Society.

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‘Some anti-epileptic drugs that are known to impair cognitive function can increase the risk Alzheimer's disease by 20 percent and dementia risk by 60 percent.’

Prolonged use for up to more than one year has been associated with 30 percent increased risk of dementia in the German data set, and a 15 percent increased risk of Alzheimer's Disease in Finnish data set.

When the researchers from the University of Eastern Finland and the German Center for Neurodegenerative Diseases, DZNE compared different antiepileptic drugs, they found that the risk of Dementia and Alzheimer's disease was specifically associated with drugs that impair cognitive function. These drugs, later on, came to be associated with 20 percent increased risk of Alzheimer's disease and with a 60 percent increased the risk of dementia.

Higher doses of anti-epileptic drugs that are known to impair cognitive function were also associated with increased risk of dementia, while other drugs that do not impair cognitive processing were not associated with the risk.

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The risk of developing Alzheimer's disease increases sharply with age. Today, it affects more than 5 million Americans.

Anti-epileptic drugs that have an effect on cognitive function include-

Phenobarbital
Valproic acid
Carbamazepine
Phenytoin
Oxcarbazepine
Ethosuximide

"More research should be conducted into the long-term cognitive effects of these drugs, especially among older people," Senior Researcher Heidi Taipale from the University of Eastern Finland says.

Besides epilepsy, these anti-epileptic drugs are also prescribed for the treatment of neuropathic pain, bipolar disorder, and generalized anxiety disorder. This is the largest study on the anti-epileptic medications and is also the first to investigate the association of regions of use and dose. They have also compared the risk of antiepileptic drugs with and without cognitive-impairing effects.

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The anti-epileptic drug has been flagged for several years due to the high risk of birth defects but also for increased risks of mental retardation and autism.

This association between antiepileptic drugs and the onset of Alzheimer's disease was assessed in Finnish persons diagnosed with Alzheimer's disease and their controls. This study is a part of MEDALZ study, which includes 70,718 persons diagnosed with Alzheimer's disease in Finland during 2005-2011 and their 282,862 controls.

And another study which checked the association of use of antiepileptic drugs and dementia was first assessed in a sample from a large German statutory health insurance provider, Allgemeine Ortskrankenkasse (AOK). This database included 20,325 people diagnosed with dementia in 2004-2011, and their 81,300 controls.

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This study also needs to look at young children who are on life long anti-epileptic medications.

Reference

Heidi Taipale, Willy Gomm, Karl Broich, Wolfgang Maier, Anna‐Maija Tolppanen, Antti Tanskanen Phil Lic, 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).https://doi.org/10.1111/jgs.15358

Source-Medindia