Preliminary research published in Neurology suggests that GLP-1 medications, including drugs such as Ozempic, may be associated with a modestly lower risk of developing epilepsy in people with type 2 diabetes compared with DPP-4 inhibitors. In the analysis, GLP-1 users were 16 percent less likely to develop epilepsy after statistical adjustment, but researchers stress that the findings show an association, not proof of cause and effect.
Early research reported by the American Academy of Neurology and ScienceDaily in December 2025 describes a possible link between GLP-1 receptor agonists—widely used for type 2 diabetes and weight management—and a reduced likelihood of epilepsy.
The study, published on December 10, 2025, in Neurology, the medical journal of the American Academy of Neurology, analyzed data from a large U.S. health database that included adults with type 2 diabetes who started treatment with either a GLP-1 drug or a dipeptidyl peptidase-4 (DPP-4) inhibitor. None of the participants had a previous diagnosis of epilepsy or seizure.
Researchers focused on three GLP-1 medications: dulaglutide, liraglutide and semaglutide, the active ingredient in Ozempic. According to the Neurology report summarized by the American Academy of Neurology and ScienceDaily, the analysis included 452,766 people with an average age of 61. Roughly half were prescribed GLP-1 drugs and half received DPP-4 inhibitors.
Participants were followed for at least five years. During that time, 1,670 people taking GLP-1 medications developed epilepsy, or 2.35%, compared with 1,886 people taking DPP-4 inhibitors, or 2.41%. After researchers adjusted for other health conditions that could affect epilepsy risk—such as age, high blood pressure and cardiovascular disease—they found that people using GLP-1 drugs were 16% less likely to develop epilepsy than those using DPP-4 inhibitors.
When the team assessed individual medications, semaglutide showed the strongest association with a lower risk of epilepsy among the GLP-1 drugs studied, according to the American Academy of Neurology press materials.
Study author Edy Kornelius, MD, PhD, of Chung Shan Medical University in Taichung, Taiwan, highlighted the clinical relevance of the findings. “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 increased risk for developing epilepsy later in life,” Kornelius said in a statement released by the American Academy of Neurology. He noted that epilepsy can have substantial physical, psychological and social consequences, and that many people do not respond to existing antiseizure medications.
Kornelius also said that the results may support the idea that GLP-1 drugs have neurological effects beyond blood sugar control. “More research is needed, but these findings support the theory that GLP-1 drugs may have neurological benefits beyond controlling blood sugar,” he said, while cautioning that the observational data cannot prove that the medications themselves prevent epilepsy. He emphasized that the study “does not imply that DPP-4 inhibitors are harmful in any way or that GLP-1 drugs are definitely beneficial for brain health.”
The Neurology study was supported by Chung Shan Medical University Hospital, according to the press release. The authors noted several limitations of their work. Because the research relied on retrospective observational data, unmeasured differences between people prescribed GLP-1 drugs and those given DPP-4 inhibitors may have influenced the results. The database also lacked detailed information on factors such as family history, genetic susceptibility and alcohol use, which could affect epilepsy risk.
In addition, the dual GLP-1 and GIP agonist tirzepatide was not included in the analysis because it became available after the study period began, so the findings do not address that medication. Researchers said it is also possible that cost, insurance coverage and the severity of an individual’s diabetes influenced which drug class they received, which could introduce further bias.
Overall, experts involved in the study describe the results as an early but intriguing signal that GLP-1 therapies might offer brain-related benefits for people with type 2 diabetes. They stress, however, that randomized, controlled trials and additional long-term studies will be needed before any firm conclusions can be drawn about epilepsy prevention.
