GLP-1 diabetes drugs may cut epilepsy risk, study suggests

GLP-1 medications used to treat type 2 diabetes, including semaglutide sold as Ozempic and Wegovy, may reduce the risk of developing epilepsy later in life, according to a large observational study. The strongest signal came from semaglutide, with the drug showing about a 32% lower risk of epilepsy on its own, while the GLP-1 class as a whole was associated with roughly a 16% lower risk compared with DPP-4 inhibitors.

In a Taiwanese cohort of 452,766 adults who were new users of GLP-1 medications or DPP-4 inhibitors, researchers tracked epilepsy diagnoses over time. At baseline, none had a prior epilepsy or seizure diagnosis. Epilepsy was diagnosed in 1,670 GLP-1 users (2.35%) versus 1,886 DPP-4 users (2.41%). After adjusting for age, hypertension, cardiovascular disease and other factors, GLP-1 users had a 16% lower risk of developing epilepsy than those on DPP-4 inhibitors, with semaglutide alone reducing risk by 32%. The results for liraglutide and dulaglutide did not reach statistical significance, suggesting the observed protective effect was driven mainly by semaglutide.

“More research is needed, but these findings support the theory that GLP-1 drugs may have neurological benefits beyond controlling blood sugar,” said Dr. Edy Kornelius, the study’s lead author and an expert in diabetes and endocrine disorders. He added that the findings do not imply that DPP-4 inhibitors are harmful or that GLP-1 drugs will definitively prevent brain disease; they simply indicate a potential association requiring further study. The study was published in Neurology and contributes to a broader discussion about non-glycemic benefits of GLP-1 therapies.

The possibility that GLP-1 medications could influence brain health is notable because epilepsy is a common neurological condition. In the United States, epilepsy affects about 3 million adults and nearly 500,000 children, with varying degrees of impact on daily life. Diabetes and epilepsy are known to co-occur more often than expected, and high blood sugar can damage brain cells, inflammatory pathways and insulin signaling in the brain, factors that may influence seizure thresholds. The potential interplay between diabetes therapies and brain health matters for millions: GLP-1 drugs are widely used for type 2 diabetes and obesity, with roughly 41 million Americans having taken or currently using GLP-1 therapies.

While the new study adds to a growing body of evidence suggesting additional benefits beyond glucose control, researchers emphasize that it does not prove causation. Clinical trials would be needed to establish whether GLP-1 medications can reliably reduce epilepsy risk. Nonetheless, the findings point to an intriguing avenue for understanding how metabolic therapies might shape brain health in people with diabetes.