Antiepileptic drug use associated with elevated stroke risk in Alzheimer’s patients

Antiepileptic drug use is associated with an increased risk of stroke among persons with Alzheimer’s disease, according to a new study from the University of Eastern Finland. The risk did not differ between old and new antiepileptic drugs. The results were published in the Journal of the American Heart Association. The risk of stroke was particularly elevated for the first three months of antiepileptic drug use, and remained elevated after accounting for several chronic disorders, socioeconomic position and use of concomitant medications.

According to another recent study from the same research group, persons with Alzheimer’s disease use antiepileptic drugs more often than persons without Alzheimer’s disease. The difference was not explained by epilepsy, and there was a considerable increase in antiepileptic drug use around the time when Alzheimer’s disease was diagnosed.

Up to 1% of population needs chronic antiepileptic treatment to control epilepsy. Other indications for antiepileptic drug use include neuropathic pain and dementia-related behavioral symptoms in persons with Alzheimer’s disease.

The present findings indicate that as persons with Alzheimer’s disease are particularly susceptible to adverse events, the use of antiepileptic drugs for other indications than epilepsy or neuropathic pain should be carefully considered in this vulnerable population.

The studies were based on the nationwide register-based MEDALZ cohort that includes all community-dwelling persons with clinically verified diagnosis of Alzheimer’s disease in Finland during 2005–2011 (70,718 people). Data on antiepileptic drug use was extracted from the Finnish Prescription Register. To assess the risk of stroke associated with antiepileptic drug use, each antiepileptic drug user was matched to a non-user. The study was conducted at the University of Eastern Finland and funded by the Academy of Finland.