GLP-1 drugs like Ozempic, Trulicity and Victoza were associated with a slightly lower likelihood of developing epilepsy in a large group of people with type 2 diabetes.
- GLP-1 drugs may be connected to a lower chance of developing epilepsy in people with type 2 diabetes, offering an intriguing early signal for researchers.
- Participants who used GLP-1 medications were 16% less likely to develop epilepsy compared with those who took DPP-4 inhibitors.
- Among the GLP-1 options studied, semaglutide showed the strongest association with reduced epilepsy risk.
- These results come from preliminary research and do not establish cause and effect; well-designed randomized, controlled trials are still needed.
- Tirzepatide was not evaluated in this analysis because it became available after the study period.
Early evidence links diabetes medications to epilepsy risk
A new preliminary study suggests that people with diabetes who use glucose-lowering GLP-1 drugs may have a lower chance of developing epilepsy. The findings were published on December 10, 2025, in Neurology, the medical journal of the American Academy of Neurology. GLP-1 drugs, officially called glucagon-like peptide-1 receptor agonists, are commonly prescribed for type 2 diabetes and weight management. Well-known brand names in this class include Ozempic (semaglutide), Trulicity (dulaglutide), and Victoza (liraglutide).
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 the study compared GLP-1 drugs with other diabetes treatments
To investigate the possible connection, researchers reviewed data from a large U.S. health database. They focused on adults with type 2 diabetes who began treatment with either a GLP-1 drug or a different medication class known as dipeptidyl peptidase-4 inhibitors (called DPP-4 inhibitors or gliptins). None of the participants had a prior diagnosis of epilepsy or seizure. The GLP-1 drugs examined were dulaglutide, liraglutide and semaglutide.
The analysis included 452,766 people with an average age of 61. Roughly half used GLP-1 medications and the other half took DPP-4 inhibitors. Each person was followed for at least five years. During that time, 1,670 people in the GLP-1 group developed epilepsy, or 2.35%, compared with 1,886 people in the DPP-4 group, or 2.41%.
Adjusted results show a modest reduction in epilepsy risk
Researchers then accounted for other health conditions that can influence epilepsy risk, such as age, high blood pressure and cardiovascular disease. After these adjustments, they found that people taking GLP-1 drugs were 16% less likely to develop epilepsy than those taking DPP-4 inhibitors.
When the team examined individual medications, semaglutide showed the strongest connection with a reduced epilepsy risk.
Possible neurological effects and drugs not included
“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.”
Kornelius also explained that tirzepatide, a dual GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptor agonist, was not included in the study because it became available after the study period began. As a result, the findings may not apply to tirzepatide.
Important limitations and missing information
Along with the limits of its retrospective observational design, the study had several other constraints. Researchers lacked information on additional influences that could shape epilepsy risk, including family medical history, genetic susceptibility or alcohol use. It is also possible that factors such as treatment cost, insurance coverage or how advanced a person’s diabetes was played a role in which medication they were prescribed, which could create differences between the two groups that were difficult to fully measure.
Reference: “Association Between GLP-1 Receptor Agonist Use and Epilepsy Risk in Type 2 Diabetes” by Ching-Yang Cheng, Shih-Chang Lo, Chien-Ning Huang, Yi-Sun Yang, Yu-Hsun Wang and Edy Kornelius, 10 December 2025, Neurology.
DOI: 10.1212/WNL.0000000000214509
The study was supported by Chung Shan Medical University Hospital.
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