GLP-1 medications, commonly used for type 2 diabetes, were linked to a possible reduction in epilepsy risk, offering an encouraging early signal for researchers. Participants who used GLP-1 drugs were 16 percent less likely to develop epilepsy compared with those who took DPP-4 inhibitors. Among the GLP-1 options studied, semaglutide stood out with the strongest association to a lower epilepsy risk. The findings come from preliminary research and do not confirm cause and effect, so randomized, controlled clinical trials are still needed. Tirzepatide was not part of the analysis because it was introduced after the study period began. Early research suggests a possible connection between GLP-1 drugs and epilepsy risk A preliminary study involving people with diabetes has found a possible link between the use of glucose-lowering GLP-1 drugs and a reduced chance of developing epilepsy. The findings were released on December 10, 2025, in Neurology, the medical journal of the American Academy of Neurology. GLP-1 drugs, known scientifically as glucagon-like peptide-1 receptor agonists, are commonly used to manage diabetes and support weight loss. The study does not prove that GLP-1 drugs lower the risk of developing epilepsy; it only shows an association. "Additional randomized, controlled trials that follow people over time are needed to confirm these findings, but these results are promising, since people with diabetes are at increased risk for developing epilepsy later in life," said study author Edy Kornelius, MD, PhD, of Chung Shan Medical University in Taichung, Taiwan. "Epilepsy can have many physical, psychological and social consequences, and many people do not respond to the current medications, so finding ways to reduce this risk is critical." How researchers compared GLP-1 drugs with other diabetes medications To explore this potential relationship, researchers reviewed data from a U.S. health database that included adults with type 2 diabetes. These individuals had begun treatment with either a GLP-1 drug or a different type of diabetes medication called a dipeptidyl peptidase-4 inhibitor (known as DPP-4 inhibitors or gliptins). None of the participants had a prior diagnosis of epilepsy or seizure. The GLP-1 medications included dulaglutide, liraglutide and semaglutide. The study followed 452,766 people with an average age of 61. Half of them were prescribed GLP-1 drugs, and the other half received DPP-4 inhibitors. Each person was monitored for at least five years. During that time, 1,670 people using GLP-1 medications developed epilepsy, or 2.35%, compared with 1,886 people taking DPP-4 inhibitors, or 2.41%. Adjusted results show a modest reduction in epilepsy risk After the researchers accounted for other health conditions that might influence epilepsy risk, including age, high blood pressure and cardiovascular disease, they found that people taking GLP-1 drugs were 16% less likely to develop epilepsy than people using DPP-4 inhibitors. When the team evaluated the individual GLP-1 medications, semaglutide showed the strongest association with a lower epilepsy risk. "More research is needed, but these findings support the theory that GLP-1 drugs may have neurological benefits beyond controlling blood sugar," Kornelius said. "It should be noted that these findings do not imply that DPP-4 inhibitors are harmful in any way or that GLP-1 drugs are definitely beneficial for brain health." Additional considerations and study limitations Kornelius also noted that tirzepatide, a dual GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptor agonist, was not part of the analysis because it became available after the study period began. As a result, the findings may not apply to tirzepatide. In addition to the limitations of the retrospective, observational design, researchers lacked information on several other factors that might influence epilepsy risk, such as family medical history, genetic susceptibility or alcohol use. It is also possible that cost, insurance requirements or the severity of a person's diabetes played a role in which medication they were prescribed, which could create differences between the groups that were not fully captured. The study was supported by Chung Shan Medical University Hospital.
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