Research Square · Oct 18, 2026
Antiseizure Medication Use and Multidimensional Biological Aging: A UK Biobank Study
By Xing# J, Ding S, Zhou# Z et al.
Background Antiseizure medications (ASMs) are commonly prescribed for prolonged treatment of epilepsy and other neurological or psychiatric conditions, but their association with biological aging is uncertain. We examined ASM use in relation to multiple biological aging indicators in the UK Biobank. Methods This cross-sectional analysis included 322,065 participants, of whom 4,940 were classified as continuous ASM users for at least 1 year before baseline. Outcomes were Klemera-Doubal method (KDM) age residual, Phenotypic Age (PhenoAge) residual, log-transformed homeostatic dysregulation (HD-log), and Z-standardized leukocyte telomere length (Z-LTL). Associations were estimated using multivariable linear regression and 1:3 propensity score matching. Drug-specific analyses compared individual monotherapies with non-use and, separately, with other ASM monotherapies. Results After matching, ASM use was associated with higher HD-log (β = 0.184, 95% confidence interval [CI] 0.152 to 0.216), KDM residual (β = 0.818 years, 95% CI 0.646 to 0.990), and PhenoAge residual (β = 0.654 years, 95% CI 0.482 to 0.826), and with lower Z-LTL (β = -0.057, 95% CI -0.090 to -0.024). Drug-specific estimates were heterogeneous. In one-versus-rest analyses, lamotrigine and topiramate were associated with lower values for selected indicators, whereas gabapentin, pregabalin, and phenytoin were associated with higher values for selected indicators. Conclusions ASM use was associated with less favorable profiles across several physiological and molecular aging indicators. The cross-sectional design and potential residual confounding, particularly by treatment indication, preclude causal interpretation.