Objective: To investigate the association between antiepileptic drugs (AEDs) prescription and subsequent Parkinson’s disease (PD).

Background: Recent observational studies have highlighted an association between epilepsy and increased risk of PD [1, 2], and separately an association between AED prescription and subsequent PD [3]. More evidence on the association between AEDs and PD is needed, especially in diverse populations.

Method: This nested case-control study was conducted using electronic health primary care records in East London, an area with an ethnically diverse population with relatively high socioeconomic deprivation. All individuals with a diagnosis of PD were included as cases and 5 controls were matched for each patient by age and sex. AEDs of first prescription were extracted from prescription data. Participants in whom a first AED was prescribed after PD diagnoses were excluded from analyses. Logistic regression was performed adjusting for age, sex, ethnicity, index of multiple deprivation, and epilepsy diagnosis. A sensitivity analysis was performed by excluding data with AEDs prescribed less than 2 years before PD diagnosis to reduce reverse causation.

Results: In total, 1055 PD cases and 5275 controls were identified. After excluding participants with a first AED prescription after PD diagnosis, 1027 cases and 5147 controls remained. A higher proportion of cases had at least one AED prescription (29.2%) than controls (12.2%). The adjusted odds ratio (aOR) was 2.97 (confidence interval [CI]: 2.52 – 3.50, p<0.001), indicating an association between AED prescription and subsequent PD diagnosis. The strength of this association partially attenuated in a 2-year-lag sensitivity analysis with aOR = 2.41 (CI: 1.32 – 4.19, p=0.003).

Conclusion: This study found evidence of an association between AEDs and new diagnoses of PD; a finding consistent with a previous study [3]. This finding serves as replication in an ethnically diverse and deprived population. Future studies are warranted to further explore the nature of this association as well as the association in different classes of AEDs.

References: 1. Simonet C, Bestwick J, Jitlal M, Waters S, Ben-Joseph A, Marshall CR, et al. Assessment of risk factors and early presentations of Parkinson disease in primary care in a diverse UK population. JAMA neurology. 2022;79(4):359-69.
2. Gruntz K, Bloechliger M, Becker C, Jick SS, Fuhr P, Meier CR, et al. Parkinson disease and the risk of epileptic seizures. Annals of Neurology. 2018;83(2):363-74.
3. Belete D, Jacobs BM, Simonet C, Bestwick JP, Waters S, Marshall CR, et al. Association Between Antiepileptic Drugs and Incident Parkinson Disease. JAMA neurology. 2023;80(2):183-7.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-between-antiepileptic-drugs-and-subsequent-parkinsons-disease-in-east-london/