Objective: To perform a meta-analysis to show the association between different Antiepileptic Drugs(AEDs) and Parkinson’s disease(PD).

Background: PD is a neurodegenerative disorder affecting 1-2% of persons over 60 and is more common as people age. The prevalence of PD has been rising over the past few decades, making it the neurological disorder with the most significant increase in incidence worldwide. The apparent link between epilepsy and  PD is believed to be from AEDs. Only a small number of studies have found a connection between AED and a subsequent PD diagnosis.

Method: The study was conducted per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline. Researchers searched PubMed, EMBASE, and Google Scholar for English literature from inception to August 1, 2023. Observational studies with PD and Non-PD cases with AED exposure excluding first AED were included.  The analysis was done by Revman 5.3. 

Results: Only three studies were included. AED prescription was found among 12.33% of patients in the PD cases compared to 6.36% of patients in the Non-PD cases with a significant association. (OR: 2.22; 95% CI: 1.64– 2.99; I2 = 91%; P<0.00001).(Figure 1) Among the exposure to routinely used AEDs, all showed significant association which is Carbamazepine(OR: 1.44; 95% CI: 1.23– 1.69; I2 = 0%; P<0.00001), Lamotrigine(OR: 2.13; 95% CI: 1.58– 2.88; I2 = 0%; P<0.00001), Levetiracetam( OR: 1.89; 95% CI: 1.56– 2.30; I2 = 44%; P<0.00001) and sodium valproate (OR: 4.00; 95% CI: 3.19– 5.02; I2 = 0%; P<0.00001).  

Conclusion: Our meta-analysis showed a significant association between AED prescription and incident PD cases of different ethnic background populations. Further studies are warranted to know the nature of the association, further clarification on drug-induced Parkinsonism, and other confounding risk factors.

Forest plot showing pooled Odds ratio(ORs).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-between-antiepileptic-drugs-and-parkinsons-disease-a-strong-or-weak-link/