Anti-epileptic drugs increase the pneumonia risk in people with Alzheimer’s

Concept image of Alzheimer's to illustrate the idea that anti-epileptic drugs increase the pneumonia risk in people with Alzheimer's
© iStock/kunertus

The first study to investigate the association between the use of anti-epileptic drugs and the pneumonia risk in people with Alzheimer’s has taken place.

Although a previous study has assessed the risk of pneumonia among younger adults and did not find a risk increase, the new study from the University of Eastern Finland has found that anti-epileptic drugs increased the pneumonia risk in patients with Alzheimer’s disease. The study showed that although the risk was highest in the beginning of use of the drugs, the risk remained elevated even in long-term use.

The use of anti-epileptics for Alzheimer’s patients

Less than ten percent of the users had been diagnosed with epilepsy. It is likely that many of the patients instead used the anti-epileptic drugs more other symptoms, such as the behavioural symptoms of dementia, or neuropathic pain.

Which anti-epileptic drugs are associated with increased risk?

Of the specific anti-epileptic drugs, the following were associated with an increased risk of pneumonia in the study:

  • Phenytoin;
  • Carbamazepine;
  • Valproic acid; and
  • Pregabalin.

Explaining the increased pneumonia risk

Some antiepileptic drugs have sedative effects. This may explain the associated risk of pneumonia for Alzheimer’s patients taking the drugs.

Senior Researcher Heidi Taipale, from the University of Eastern Finland, commented: “Further research into whether older persons are more sensitive to the effects of anti-epileptic drugs is needed. Persons with Alzheimer’s disease have a higher risk of pneumonia and pneumonia-related mortality than persons without the disease. For this reason, it is important to carefully assess the risks and benefits of drug use, especially for other indications than epilepsy.”

Further information on the study

The results have been published in the Journal of Alzheimer’s Disease. It was based on the nationwide register-based MEDALZ study, which was conducted at the University of Eastern Finland. The researchers included 5,769 community-dwelling persons diagnosed with Alzheimer’s disease who initiated antiepileptic drug use in Finland, which were compared with matched non-users of these drugs.

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