Some Blood Pressure Drugs May Prevent Epilepsy, Study Finds

A class of drugs already on the market to lower blood pressure appears to reduce adults’ risk of developing epilepsy, Stanford Medicine researchers and their colleagues have discovered. The finding comes out of an analysis of the medical records of more than 2 million Americans taking blood pressure medications.

The study, published June 17 in JAMA Neurology, suggests that the drugs, called angiotensin receptor blockers, could prevent epilepsy in people at highest risk of the disease, including older adults who have had strokes.

“This is incredibly exciting because we don’t currently have any medicines that prevent epilepsy,” said Kimford Meador, MD, a professor of neurology and neurological sciences and the senior author of the paper. “I hope these initial findings lead to randomized clinical trials.”

Preventing seizures after stroke

While epilepsy is often diagnosed during childhood, more than 1% of people over age 65 are diagnosed with the recurring seizures that characterize the disorder. These seizures can temporarily disrupt the brain’s function and cause a range of symptoms.

In older adults, the most common risk factor for developing epilepsy is stroke; about 10% of stroke survivors experience seizures within five years. Vascular disease and chronic high blood pressure, even in the absence of stroke, also boost epilepsy risk.

“This can be a very debilitating disorder, and it’s much more common in older adults than people realize,” said Meador, a member of the Wu Tsai Neurosciences Institute.

Although anti-seizure medications can be used to control epilepsy after diagnosis, no drugs are approved to prevent epilepsy in people at high risk of developing the disorder.

During the past decade, however, studies have suggested that one type of blood pressure medication might help quell seizures because of their ability to tamp down inflammation. This aspect would be particularly apt for preventing seizures that follow stroke or traumatic brain injuries, as both cause brain inflammation that can trigger epilepsy.

In 2022, a study of more than 160,000 people in Germany found that people taking angiotensin receptor blockers — one of multiple classes of drugs prescribed to treat high blood pressure — had a diminished risk of developing epilepsy. The drugs block certain hormone receptors, leading to lower blood pressure and decreased inflammation in blood vessels and other organs — including the brain.

“Those results out of Germany echoed what had been found in animal studies and seemed very promising, but I felt that it was important to reproduce that analysis using data on people in the U.S.,” Meador said.