A large new study has revealed a surprising potential benefit for a popular class of diabetes and weight-loss medications. People with type 2 diabetes who use glucagon-like peptide-1 (GLP-1) receptor agonists, drugs like Ozempic (semaglutide), Trulicity (dulaglutide), and Victoza (liraglutide), may have a lower risk of developing epilepsy compared to those using another common type of diabetes drug. The research, published in the journal Neurology, offers an intriguing early signal that these medications could have protective effects on the brain, though scientists caution that more rigorous studies are needed to confirm a direct link.
The analysis, led by Dr. Edy Kornelius of Chung Shan Medical University in Taiwan, examined health data from over 450,000 U.S. adults with type 2 diabetes. All participants began a new treatment regimen with either a GLP-1 drug or a dipeptidyl peptidase-4 (DPP-4) inhibitor, another class of glucose-lowering medication. None had a prior diagnosis of epilepsy or seizures. Researchers followed the groups for at least five years, tracking who developed epilepsy.
The results showed a modest but notable difference. In the group taking GLP-1 drugs, 1,670 people (2.35%) were diagnosed with epilepsy during the study period. In the comparison group taking DPP-4 inhibitors, 1,886 people (2.41%) developed the condition. After statistically adjusting for other factors that influence epilepsy risk, such as age, high blood pressure, and cardiovascular disease, the researchers calculated that the GLP-1 group had a 16% lower risk of developing epilepsy.
When the team looked at individual GLP-1 medications, semaglutide (the active ingredient in Ozempic and Wegovy) showed the strongest statistical association with reduced epilepsy risk. “These findings support the theory that GLP-1 drugs may have neurological benefits beyond controlling blood sugar,” said Dr. Kornelius. The discovery is particularly significant because people with diabetes are known to have a higher lifetime risk of developing epilepsy. “Finding ways to reduce this risk is critical,” Kornelius added, noting that epilepsy carries substantial physical, psychological, and social burdens and that many patients do not achieve full seizure control with current anti-epileptic drugs.
Despite the encouraging numbers, the study authors and independent experts emphasize a crucial limitation: this research demonstrates an association, not proof of cause and effect. The study design was observational, meaning it analyzed existing health records rather than randomly assigning patients to different treatments in a controlled clinical trial. This approach makes it difficult to rule out other factors that could explain the difference in risk. For instance, the severity of a patient’s diabetes, their insurance coverage, medication costs, or unmeasured lifestyle and genetic factors could have influenced which drug they were prescribed and their overall health outcomes.
The study also had specific gaps. It did not include the newer drug tirzepatide (Mounjaro, Zepbound), a dual GLP-1 and GIP receptor agonist, as it entered the market after the study period began. Therefore, the findings cannot be extended to that medication. Researchers also lacked data on important epilepsy risk factors like family history, genetic predisposition, and alcohol consumption.
“Additional randomized, controlled trials that follow people over time are needed to confirm these findings,” Kornelius stated. Such trials would provide a higher level of evidence by directly comparing GLP-1 drugs to other treatments or a placebo while carefully controlling for other variables.
This study adds to a growing body of research investigating the potential broader benefits of GLP-1 medications, which are already revolutionizing the treatment of type 2 diabetes and obesity. Scientists are actively exploring their effects on conditions ranging from heart and kidney disease to addiction and neurodegenerative disorders like Alzheimer’s. The possible link to epilepsy risk opens another promising, though preliminary, avenue for understanding how these drugs interact with the brain. For now, the results offer a compelling reason for the scientific community to prioritize further investigation into the neuroprotective potential of this influential class of drugs.