- A large database study found people with type 2 diabetes on GLP 1 drugs were less likely to develop epilepsy than those on DPP 4 inhibitors
- The difference was small in absolute terms, but still showed up after adjustments for other health factors
- It is an association, not proof, and the authors say proper randomised trials are needed
A new analysis suggests GLP 1 receptor agonists, the diabetes drugs that include semaglutide, dulaglutide and liraglutide, may be linked with a modestly lower risk of developing epilepsy in people with type 2 diabetes.
Researchers looked back through a large US health database and compared adults who started a GLP 1 drug with similar adults who started a DPP 4 inhibitor, sometimes called a gliptin.
Nobody included had epilepsy or seizures at baseline.
The average age was 61 and the study followed people for at least five years.
Over that period, epilepsy was diagnosed in 2.35% of people using GLP 1 drugs and 2.41% of people using DPP 4 inhibitors.
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After accounting for differences such as age, high blood pressure and cardiovascular disease, GLP 1 use was associated with a 16% lower likelihood of epilepsy.
When individual drugs were compared, semaglutide had the strongest association with lower risk.
It is worth keeping your feet on the ground here.
This is not a trial, so it cannot show that GLP 1 drugs prevent epilepsy.
Prescribing patterns can be messy and the researchers did not have data on several things that could affect epilepsy risk, such as family history, genetic susceptibility and alcohol use.
Cost and insurance rules can also influence which drug someone gets, which can quietly skew results.
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The authors also note that tirzepatide was not included because it entered use after the study period began, so you cannot apply these findings to that drug.
For now, the practical message is simple: there is an interesting signal that GLP 1 drugs might have effects beyond glucose control, but it needs confirmation in controlled studies before anyone should treat it as a brain health benefit.
Reference: Cheng CY et al. Association Between GLP 1 Receptor Agonist Use and Epilepsy Risk in Type 2 Diabetes. Neurology. 2026;106(1). DOI: 10.1212/WNL.0000000000214509
