Authors :
Presenting Author: Yugant Khand, MBBS – Nepalese Army Institute of Health Sciences
Sanjeev Kharel, MBBS – Institute of Medicine
Romil Kukadiya, MBBS – Pramukhswami Medical College
Egesh Aryal, MBBS – Nepalese Army Institute of Health Sciences
Priya Mainali, MBBS – Nepalese Army Institute of Health Sciences
Agya Mainali, MBBS – Nepalese Army Institute of Health Sciences
Rationale:
Although observational studies suggest a possible association between antiseizure medication (ASM) use and Parkinson’s disease (PD), the evidence remains inconsistent. Currently, there is no consensus on whether ASMs contribute directly to PD pathogenesis or whether the relationship is incidental. It is unclear whether the observed association reflects a direct causal relationship, drug-induced parkinsonism that mimics PD or the influence of confounding factors such as age, comorbidities, or genetic predisposition. We conducted a systematic review and meta-analysis to provide a comprehensive synthesis of existing evidence and highlight potential differences across specific ASM classes and populations. This could improve clinical awareness, inform prescribing practices, and guide future mechanistic and epidemiological studies.
Methods:
The study was conducted per the PRISMA guideline. Researchers searched PubMed, EMBASE, and Google Scholar for English literature from inception to January 1, 2025. Five studies met the inclusion criteria, with data on various AEDs including carbamazepine, lamotrigine, levetiracetam, and sodium valproate. Pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using random effects model, and heterogeneity was assessed using the I2 statistics.
Results:
Five studies were included and the overall meta-analysis showed that AED users had a significant risk of developing PD compared to non-users (OR: 1.63, 95% CI: 1.04-2.56; p = 0.03). Sub-group analysis revealed drug-specific association. The relationship between parkinsonism and ASMs were statistically significant for carbamazepine (OR: 1.31; 95% CI: 1.18– 1.46; I2 = 25%), lamotrigine (OR: 2.13; 95% CI: 1.58– 2.88; I2 = 0%), levetiracetam (OR: 1.89; 95% CI: 1.56– 2.30; I2 = 44%) and sodium valproate (OR: 4.00; 95% CI: 3.19– 5.02; I2 = 0%).
Conclusions:
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.
Funding:
There are no financial and non-financial funding in our study.