Can you take Wegovy if you have epilepsy?

Jump to: How Wegovy may affect seizures | Anti-epileptic drug interactions | Obesity and epilepsy | Foods to focus on | Physical activity | Mental health and epilepsy | When to speak to your GP | FAQs | Take home message

You can take Wegovy (semaglutide) if you have epilepsy, but you should do so under the supervision of both your prescriber and your neurologist or epilepsy specialist. Epilepsy isn’t listed as a contraindication in the Wegovy prescribing information.¹

Around 600,000 people in the UK live with epilepsy. Research suggests that people with epilepsy are 28% more likely to have obesity than the general population, partly driven by anti-epileptic drugs (AEDs) that cause weight gain as a side effect.²

The relationship between epilepsy and weight creates a cycle. AEDs contribute to weight gain, and excess weight has been associated with a higher risk of drug-resistant epilepsy.³

If you’re considering Wegovy for weight management alongside epilepsy, there are some interactions and monitoring considerations we’ll cover in this guide.

How Wegovy may affect seizures

Wegovy contains semaglutide, a GLP-1 receptor agonist. GLP-1 receptors are found not only in the gut and pancreas but also in the brain. Emerging research suggests that activating these receptors may have neuroprotective effects.

A 2024 meta-analysis of 27 randomised controlled trials involving approximately 200,000 participants found that GLP-1 receptor agonists were associated with a 24% reduced risk of seizures and epilepsy compared to placebo.⁴

A separate 2025 retrospective study of over 450,000 matched patients found that semaglutide specifically was associated with the strongest protective effect among GLP-1 receptor agonists, with a 32% reduction in epilepsy risk.⁵

The proposed mechanisms include reduced neuroinflammation, decreased oxidative stress in the brain, and enhanced neurotrophic signalling.

These findings come from observational data and retrospective analyses rather than prospective trials in people with epilepsy, so they should be interpreted with caution.

There’s no evidence that semaglutide lowers the seizure threshold or increases seizure risk.

Anti-epileptic drug interactions

Semaglutide doesn’t significantly affect the cytochrome P450 enzyme system, which is the primary metabolic pathway for many medications.

The Wegovy prescribing information confirms that no clinically relevant drug-drug interactions were identified in pharmacology studies.¹

Lamotrigine

A case series presented at the American Epilepsy Society reported two cases of lamotrigine toxicity following the initiation of GLP-1 receptor agonists.⁶

In one case involving semaglutide, lamotrigine blood levels rose from a baseline of 10.9-14.3 mcg/ml to 32.4 mcg/ml over six weeks. Levels returned to normal after semaglutide was stopped and the lamotrigine dose was adjusted.

The proposed mechanism is that GLP-1 receptor agonists may delay gastric emptying, thereby prolonging lamotrigine absorption. This is particularly relevant for extended-release formulations.

If you take lamotrigine, your neurologist should monitor your blood levels more closely when starting Wegovy and during dose escalation.

Other common AEDs

For most commonly prescribed AEDs, no pharmacokinetic interaction with semaglutide is expected. The exception being lamotrigine, where closer monitoring is advised.

Obesity and epilepsy

Research consistently shows a link between epilepsy and higher rates of obesity.

A 2024 meta-analysis of 17 studies found that people with epilepsy were 28% more likely to have obesity compared to the general population.²

Several factors contribute to this:

• AEDs such as sodium valproate, carbamazepine, gabapentin, and pregabalin are associated with weight gain
• Seizure-related fatigue and activity restrictions can reduce physical activity levels
• Some people with epilepsy experience changes in appetite regulation
• Obesity itself has been associated with a 2.3-fold increased risk of drug-resistant epilepsy³

This creates a cycle where AEDs contribute to weight gain, and excess weight may worsen seizure control.

Effective weight management isn’t just about overall health; it may also improve seizure outcomes.

If weight gain is a concern, it’s worth discussing your current AED regimen with your neurologist.

Some AEDs are weight-neutral (levetiracetam, lamotrigine) or associated with weight loss (topiramate, zonisamide), while others commonly cause weight gain.

Switching AEDs purely for weight management isn’t always appropriate, as seizure control is the priority. But if you’re considering a medication review, weight effects can be part of that conversation.

Foods to focus on with epilepsy and Wegovy

Maintaining stable blood sugar levels is particularly important when you have epilepsy. Both hypoglycaemia and significant blood sugar fluctuations can increase neuronal excitability and potentially lower the seizure threshold.⁷

When taking Wegovy, your appetite will be reduced, so it’s important to ensure your meals are based on nutrient-dense, whole foods that support both seizure management and overall health.

Protein at every meal

Protein helps maintain muscle mass during weight loss and supports stable blood sugar levels. Aim for a palm-sized portion at each meal.

Good options include:

• Chicken, turkey, and lean red meat
• Fish, particularly oily fish like salmon, mackerel, and sardines (also good sources of omega-3, which may support brain health)
• Eggs
• Greek yoghurt
• Tofu and tempeh
• Lentils and chickpeas

Foods that help to manage blood sugar levels

Choosing foods that release energy slowly helps avoid the blood sugar spikes and dips that can affect neuronal excitability:

• Non-starchy vegetables: leafy greens, broccoli, courgettes, peppers, aubergines, tomatoes
• Complex carbohydrates: sweet potatoes, rolled oats, quinoa, brown rice, sourdough bread
• Healthy fats: avocado, olive oil, nuts, and seeds
• High-fibre foods: beans, lentils, vegetables, and berries, which slow the absorption of sugar into the bloodstream

Nutrients to pay attention to

Some AEDs can interfere with the absorption or metabolism of certain nutrients. Enzyme-inducing AEDs like carbamazepine and phenytoin can reduce vitamin D levels, and many commonly used AEDs have been shown to lower folate and vitamin B12.⁸

If you’re eating less while taking Wegovy, this makes nutrient-dense food choices even more important:

• Leafy greens (spinach, kale, broccoli) for folate and calcium
• Oily fish and eggs for vitamin D (though taking a vitamin D supplement in the winter in the UK is recommended; also consider a supplement in the summer if you don’t get regular non-burning sun exposure)
• Nuts, seeds, and dark chocolate for magnesium
• If your GP has recommended a folate or vitamin D supplement, continue taking it

Foods to limit

• Alcohol can lower the seizure threshold and interact with AEDs. Light to moderate consumption (1-2 drinks) may be tolerated, but heavy drinking significantly increases seizure risk.⁹
• Refined carbohydrates and added sugars (white bread, sugary cereals, pastries, sweets) can cause blood sugar fluctuations
• Sugary drinks, including fruit juice
• Ultra-processed foods and takeaways
• Excessive caffeine, as some individuals may find it affects their seizure control. There’s no clinical evidence to advise all people with epilepsy against caffeine, but if you notice it impacting you, discuss it with your neurologist.

Managing nausea from Wegovy

If nausea is an issue, particularly during dose escalation:

• Eat smaller, more frequent meals rather than large portions
• Avoid lying down immediately after eating
• Choose easily digestible foods during the first few weeks (scrambled eggs, white fish, mashed potatoes, cooked vegetables, soups, smoothies)
• Ginger tea or ginger supplements may help settle your stomach
• If nausea leads to vomiting shortly after taking your AED, speak to your prescriber, as it could reduce absorption of that dose

Physical activity

There’s a common misconception that people with epilepsy should avoid exercise. However, a 2022 systematic review of 14 studies involving 331 people with epilepsy found that physical exercise did not increase seizure frequency.¹⁰

The same review found that regular exercise led to significant improvements in quality of life, fitness, and mood in people with epilepsy.

Exercise can also improve insulin sensitivity independently of weight loss, which is relevant for overall metabolic health.

Safe activities for most people with epilepsy

Most forms of exercise are safe for people with well-controlled epilepsy:

• Walking, jogging, and running
• Gym-based exercise and group fitness classes
• Cycling on flat terrain
• Team sports (football, basketball, cricket)
• Yoga and tai chi, which may also help manage stress

Any movement is better than none, and building a small, consistent habit matters more than hitting a specific target.

A 10-minute walk after dinner is a practical starting point that you can build on over time.

Research suggests it takes an average of 66 days for a new behaviour to become automatic, and linking a new activity to an existing routine can help it stick.¹¹ Gradually do a little more as it feels manageable.

Resistance training

Resistance training (bodyweight exercises, free weights, or resistance bands) helps maintain muscle mass during weight loss, which is especially important when taking Wegovy.

Bodyweight exercises like squats, lunges, and press-ups are effective options that don’t require a gym. Even one session a week is a good starting point, and you can build from there.

Activities that need extra precautions

Some activities carry additional risk if you have seizures that affect awareness or consciousness:

• Swimming: always swim with a companion who knows about your epilepsy and is trained in water rescue. The Epilepsy Society recommends never swimming alone¹²
• Climbing and height-based activities: discuss with your epilepsy team based on your seizure frequency and type
• Scuba diving, hang gliding, and skydiving are generally advised against for people with uncontrolled seizures

Practical tips

• Stay hydrated, as dehydration can lower the seizure threshold
• Avoid exercising to exhaustion, as sleep deprivation can trigger seizures in some people
• Exercise with a companion when possible, particularly for new activities
• Carry a medical ID or an epilepsy alert card

Mental health and epilepsy

Epilepsy is associated with significantly higher rates of anxiety and depression.

Studies estimate that around 20-30% of people with epilepsy experience depression, and a similar proportion experience anxiety.¹³

Some screening studies have found even higher rates, with up to 50% screening positive for anxiety symptoms.

People with epilepsy have 2-3 times the risk of depression compared to the general population.

Several factors contribute to this. The unpredictability of seizures creates ongoing anxiety about when the next one might happen. The stigma associated with epilepsy can lead to social withdrawal and isolation.

Some AEDs can directly affect mood. Medications like levetiracetam and phenobarbital can worsen depression in some people, while lamotrigine and valproate may have mood-stabilising properties.

Living with driving restrictions, employment challenges, and the need to plan around seizure risks adds further psychological burden.

Finding support

• Speak to your GP or epilepsy specialist if you’re experiencing persistent low mood, anxiety, or difficulty coping
• Regular physical activity has evidence for improving both mood and quality of life in people with epilepsy¹⁰
• Cognitive behavioural therapy (CBT) has evidence for managing anxiety and depression in chronic health conditions
• Epilepsy support organisations like the Epilepsy Society and Epilepsy Action offer peer support and helplines
• If you’re starting Wegovy, be aware that the early weeks of dose escalation can be physically uncomfortable, which may temporarily affect your mood
• If you think your AED is affecting your mood, discuss this with your neurologist rather than stopping the medication

When to speak to your GP

Contact your GP, prescriber, or epilepsy specialist if you experience any of the following after starting Wegovy:

• Any change in seizure frequency or severity
• New or worsening side effects from your anti-epileptic medication (dizziness, double vision, unsteadiness, skin rash)
• Persistent nausea or vomiting that could affect AED absorption
• Significant weight loss (more than 1 kg per week over several weeks), as this may require AED dose adjustment
• If you take lamotrigine, report any unusual symptoms promptly as blood levels may need checking
• Significant mood changes or worsening mental health symptoms
• Signs of dehydration from persistent vomiting or diarrhoea (dizziness, dark urine, extreme thirst)

Frequently asked questions

Is Wegovy safe for people with epilepsy?

Epilepsy isn’t listed as a contraindication for Wegovy in the prescribing information.¹

However, you should always involve your neurologist or epilepsy specialist in the decision to start Wegovy. They can assess whether any of your current medications need closer monitoring.

Can Wegovy cause seizures?

There’s no evidence that Wegovy causes seizures or lowers the seizure threshold.

Emerging research suggests that GLP-1 receptor agonists may have a protective effect against seizures, though this hasn’t been confirmed in prospective clinical trials.⁴

Will Wegovy interact with my epilepsy medication?

For most anti-epileptic drugs, no pharmacokinetic interaction with semaglutide is expected.

The exception is lamotrigine, where case reports have documented elevated blood levels after starting a GLP-1 receptor agonist.⁶ If you take lamotrigine, your neurologist should monitor your levels more closely.

Can I take Wegovy with sodium valproate?

There’s no expected pharmacokinetic interaction between semaglutide and sodium valproate.

As valproate commonly causes weight gain, Wegovy may help manage weight while continuing your epilepsy treatment.

Can I take Wegovy with topiramate?

There’s no expected interaction between semaglutide and topiramate.

Topiramate itself is associated with weight loss, so you and your prescriber should be aware of the potential for additive weight-loss effects when taking both medications.

Will losing weight affect my seizure control?

Weight loss through medication and lifestyle changes is unlikely to negatively affect seizure control.

Some research suggests that reducing obesity may actually improve seizure outcomes.³

Rapid weight loss or significant changes in eating patterns can occasionally affect AED absorption or metabolism, so your neurologist may want to monitor your medication levels during active weight loss.

Do I need extra monitoring while taking Wegovy with epilepsy?

Your neurologist may recommend more frequent blood level checks for your AED when you start Wegovy and during dose escalation, particularly if you take lamotrigine. Track any changes in seizure frequency and report them promptly.

Can nausea from Wegovy affect my epilepsy medication?

If nausea leads to vomiting shortly after taking your AED, it could reduce absorption of that dose. If you experience regular vomiting, speak to your prescriber about timing your medications or managing the nausea.

Can I exercise safely with epilepsy?

Yes. Research shows that exercise doesn’t increase seizure frequency in most people with epilepsy.¹⁰

Take sensible precautions when engaging in water-based and height-based activities, stay hydrated, and avoid exercising to exhaustion.

Can my GP prescribe Wegovy if I have epilepsy?

Wegovy is available through specialist weight management services in the UK, as recommended by NICE.¹⁴

Having epilepsy doesn’t exclude you from eligibility, but your prescriber will need to coordinate with your neurologist or epilepsy specialist to ensure safe monitoring.

Take home message

Wegovy isn’t contraindicated in epilepsy, and emerging research suggests that GLP-1 receptor agonists may have neuroprotective properties.

The main consideration is the potential interaction with lamotrigine, which requires closer monitoring of blood levels.

For most other common AEDs, no pharmacokinetic interaction is expected.

Because erratic blood sugar levels can increase the risk of seizures and their severity, focusing on regular meals with protein, complex carbohydrates, and nutrient-dense foods is particularly important while taking Wegovy.

Regular physical activity is safe for most people with epilepsy and may improve both seizure outcomes and quality of life.

If you have epilepsy and are considering Wegovy for weight management, involve both your prescriber and your neurologist in the decision. They can help plan appropriate monitoring and ensure your seizure control remains stable.

Second Nature’s programme combines medication support with personalised nutrition and lifestyle guidance from registered dietitians and nutritionists.

The programme is built around a balanced plate model: half vegetables, quarter protein, quarter complex carbohydrates, plus a serving of healthy fat.

A peer-reviewed study published in JMIR Formative Research found that active subscribers on Second Nature’s semaglutide-supported programme lost an average of 19.1% of their body weight at 12 months, with 77.7% achieving at least 10% weight loss.¹⁵

References

1. Electronic Medicines Compendium. (2026). Wegovy 0.25 mg solution for injection in pre-filled pen: Summary of Product Characteristics.
2. Li, Y.X. et al. (2024). The relationships between obesity and epilepsy: a systematic review with meta-analysis. PLOS ONE, 19(8), e0306175.
3. Chen, M. et al. (2021). Associations of overweight and obesity with drug-resistant epilepsy. Seizure, 92, 94-99.
4. Sindhu, U. et al. (2024). Newer glucose-lowering drugs reduce the risk of late-onset seizure and epilepsy: a meta-analysis. Epilepsia Open, 9(6), 2528-2536.
5. Cheng, C.Y. et al. (2026). Association of GLP-1 receptor agonist use with epilepsy risk in type 2 diabetes. Neurology, 106(1), e214509.
6. American Epilepsy Society. (2024). Lamotrigine toxicity associated with GLP-1 agonist initiation: a case series. AES Abstract.
7. Bhatt, R. et al. (2024). The interplay between glucose homeostasis and neuronal excitability in epilepsy. Frontiers in Neurology.
8. Linnebank, M. et al. (2011). Antiepileptic drugs interact with folate and vitamin B12 serum levels. Annals of Neurology, 69(2), 352-359.
9. Samokhvalov, A.V. et al. (2010). Alcohol consumption, unprovoked seizures, and epilepsy: a systematic review and meta-analysis. Epilepsia, 51(7), 1177-1184.
10. Volpato, N. et al. (2022). The effects of physical exercise on epilepsy: a systematic review and meta-analysis. Epilepsy & Behavior.
11. Lally, P. et al. (2010). How are habits formed: modelling habit formation in the real world. European Journal of Social Psychology, 40(6), 998-1009.
12. Epilepsy Society. (2024). Exercise and sport. Epilepsy Society UK.
13. Scott, A.J. et al. (2017). Anxiety and depressive disorders in people with epilepsy: a meta-analysis. Epilepsia, 58(6), 973-982.
14. NICE. (2023). Semaglutide for managing overweight and obesity. Technology Appraisal TA875.
15. Richards, R. et al. (2025). A remotely delivered, semaglutide-supported weight management program: 12-month outcomes from a retrospective service evaluation. JMIR Formative Research, 9(1), e72577.