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Electrophoretic Delivery of γ-aminobutyric Acid GABA into Epileptic Focus Prevents Seizures in Mice
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Long-Term Medication-Induced Weight Change Across Common Antiseizure Medications: A Target Trial Emulation Study
Han Yu1, Jessica G Young1,2, Joshua Petimar1,2
1Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Obesity (Silver Spring, Md.)
|October 6, 2025
Summary
Topiramate is linked to weight loss, while other antiseizure medications (ASMs) like valproate and levetiracetam are associated with weight gain. This study compared long-term weight changes across various ASMs.
Area of Science:
- Pharmacology and Neurology
- Clinical Research on Antiseizure Medications
Background:
- Antiseizure medications (ASMs) are crucial for epilepsy management.
- Weight change is a significant side effect influencing treatment adherence and patient outcomes.
Purpose of the Study:
- To quantify long-term weight changes associated with commonly used ASMs.
- To compare weight change differences among ASMs, using topiramate as a reference.
Main Methods:
- Utilized a target trial emulation approach with 52,309 adult patients initiating ASMs.
- Controlled for time-varying confounding and selection bias.
- Assessed weight change at 6 and 12 months post-initiation and adherence.
Main Results:
- Topiramate was the most frequently initiated ASM (41.2%) and was associated with weight loss.
- Compared to topiramate, levetiracetam, lamotrigine, valproate, carbamazepine, and oxcarbazepine were associated with significant weight gain at 6 and 12 months.
- Weight changes were primarily driven by topiramate-induced weight loss rather than weight gain from other ASMs.
Conclusions:
- Topiramate demonstrated a consistent association with weight loss.
- Other ASMs showed higher weight changes, indicating potential for weight gain.
- Findings offer critical data for informed ASM selection and patient counseling.
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