Pharmacoepidemiology
Antiseizure medications use and the incidence of Parkinson’s disease: A retrospective cohort study in Manitoba, Canada Laila Aboulatta* Laila Aboulatta Qier Tan Sherif Eltonsy
Introduction
Recent studies demonstrated and association between antiseizure medications (ASMs) and an increased risk of Parkinson’s disease (PD). Our aim is to investigate the association between ASMs and incidence of PD.
Methods
Using the provincial administrative health databases in Manitoba, Canada, we conducted a population-based study including individuals aged >25 years from April 2008 to March 2022. We included all ASMs excluding clonazepam and safinamide, and examined individuals exposed to 1 ASM (monotherapy), >2 ASMs (polytherapy) and divided individuals into quartiles based on number of prescriptions issued. We examined the 7 most prescribed ASMs and defined PD diagnosis using ICD 9 and 10 codes. We used logistic regression models, adjusting for age, sex, and epilepsy to calculate ORs and 95% CI.
Results
During the study period, 63,286 individuals were exposed to ASMs and 883,667 were unexposed. Among the exposed group, 58.03% were female and 20.04% had epilepsy. We observed higher PD incidence among the exposed groups compared to the unexposed group. Excluding gabapentin, the odds of PD incidence significantly increased with any ASM use with adjusted OR of 1.34 (95%CI 1.11-1.62) and polytherapy (aOR=1.68,95% CI 1.31-2.15). Individuals in the fourth quartile, had higher odds of developing PD (aOR=2.44,95% CI 2.03-2.93) compared with individuals in quartile 1 (aOR=0.54, 95% CI 0.43-0.67). PD Incidence was significantly associated with the use of valproic acid (aOR=2.94,95% CI 2.42-3.58), levetiracetam (aOR=2.094,95% CI 1.602 -2.738), lamotrigine (aOR=1.91;95% CI 1.43-2.54), and gabapentin (aOR=1.48,95% CI 1.25-1.75).
Conclusion
Over the 15-year study period, we found an association between ASMs and PD incidence. Lamotrigine, levetiracetam, valproic acid and gabapentin were associated with increased risk of PD. Our findings provide insights into potential risks and future research are warranted to understand underlying mechanisms.