Seizing the link: Exploring the potential association between anti-seizure medications and Alzheimer's disease

Ongoing seizures in Alzheimer's disease (AD) are associated with worse cognitive and mortality outcomes. However, the relationship between anti-seizure medications (ASMs) and AD remains uncertain. This scoping review of 27 studies (1,241,796 participants) found ASM use to be associated with slightly increased AD risk, though findings were largely inconclusive. Associations between ASMs and AD-related symptoms, including mood, cognition, quality of life, function, and neuropsychiatric symptoms, were similarly mixed. The review establishes the scope of the problem, highlights the gaps, and maps available evidence. However, the included studies have methodological limitations, including inadequate control for the presence and severity of seizures, unclear ASM indications, lack of biomarker-based AD diagnosis, and limited ethnic and racial diversity, which limit conclusions and generalizability. Addressing these gaps in future studies will provide a more nuanced understanding of the relationship between seizures, ASMs, and AD.