Dementia is a complex condition with many contributing factors. According to Dementia UK, risk can be influenced by genetics, aging, brain changes, lifestyle choices, and other underlying health conditions. At its core, dementia develops when brain cells are damaged and can no longer communicate effectively with one another. This disruption gradually leads to the shrinking of specific brain regions, which in turn impacts memory, reasoning, and behavior.
Investigating Medication and Dementia Risk
Recently, researchers published a study in the journal Regional Anesthesia & Pain Medicine that explored a possible link between the commonly prescribed drug gabapentin and the potential risk of developing dementia.
Gabapentin is an FDA-approved prescription medication primarily used to treat nerve pain and manage seizures. Over the years, it has also been prescribed off-label for a wide range of conditions, including:
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Fibromyalgia
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Sciatica
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Insomnia
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Anxiety
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Hot flashes
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Chronic lower back pain
One reason gabapentin is often considered a preferred option is its lower potential for dependency compared to other medications with similar therapeutic effects.
Why This Research Matters
The findings do not mean that gabapentin directly causes dementia, but rather that there may be an association worth further exploration. Medication safety is an ongoing area of study, particularly when drugs are prescribed widely and for extended periods. Understanding long-term impacts helps healthcare professionals weigh benefits against potential risks more effectively.
Like all medications, gabapentin is not without potential side effects. Some individuals may experience nausea, dizziness, fatigue, headaches, memory difficulties, or even mild issues with speech. While many people tolerate the drug well, these effects highlight the importance of regular monitoring, especially during long-term use.
The recent study raised questions about gabapentin’s prolonged use and its possible link to cognitive health. Researchers observed that individuals who received six or more prescriptions of gabapentin for lower back pain appeared to have a higher likelihood of developing mild cognitive impairment (MCI) or dementia.
It’s important to note that the study identifies an association rather than direct causation. More research is needed to fully understand whether gabapentin itself contributes to these risks or whether other health and lifestyle factors may play a role.
The study drew on health records from more than 26,000 adults within the TriNetX research network, focusing on individuals living with chronic pain conditions such as lower back pain and lumbar radiculopathy.
Researchers compared outcomes between two groups: those who had been prescribed gabapentin and a similar group of participants who had not received the medication. To ensure a meaningful comparison, participants were divided into five age brackets and then monitored over a ten-year period.
During that time, the research team tracked whether participants developed mild cognitive impairment (MCI), Alzheimer’s disease, or vascular dementia. This long-term approach was designed to help identify whether prolonged use of gabapentin might be associated with an increased risk of cognitive decline.
Right now, there is still debate about whether gabapentin use truly raises the risk of dementia,” explained Nafis B. Eghrari, the study’s lead author and a fourth-year medical student at Case Western Reserve University School of Medicine, in an interview with Medical News Today. “We also don’t have a clear understanding of how gabapentin might influence cognitive function or whether it plays a role in neurodegenerative changes. Earlier research on this topic has produced mixed results, which is why we wanted to explore it further.”
According to the study’s analysis, individuals who received six or more prescriptions for gabapentin had a 29% greater likelihood of developing dementia and an 85% higher likelihood of developing mild cognitive impairment (MCI) compared to those who did not use the drug.
“The importance of these results is that they show an association at a national level between gabapentin prescriptions and dementia,” Eghrari noted. “This does not mean the drug directly causes dementia, but it does highlight the need for further research into its long-term impact.”
One of the most surprising findings came from the 35–49 age group, where researchers observed that the risk of dementia appeared to double, while the likelihood of developing mild cognitive impairment (MCI) tripled. Lead author Nafis B. Eghrari described this as unexpected, since neurodegenerative conditions are typically associated with people over the age of 65.
Study Limitations and Expert Criticism
Like many observational studies, this research has important limitations that need to be considered. The analysis did not account for other medical conditions or additional medications that participants might have been taking—both of which can influence dementia risk.
Tara Spires-Jones, director of the Centre for Discovery Brain Sciences at the University of Edinburgh, shared her perspective in an interview with Medscape. She noted:
“One very important factor that was not examined in this study is levels of physical activity. People with chronic pain requiring gabapentin may have been less physically active, which is a known risk factor for developing dementia.”
Similarly, Ian Maidment, professor of clinical pharmacy at Aston University in Birmingham, England, emphasized that the study did not control for treatment duration or dosage. He also pointed out that other recent studies have not found a clear connection between gabapentin and dementia, concluding that:
“The jury is out on whether gabapentin causes dementia.”
These critiques highlight the need for further research before drawing firm conclusions. While the findings raise important questions, they do not prove cause and effect.
Dr. Neel Anand, a board-certified orthopedic spine surgeon who was not involved in the study, emphasized that establishing a direct causal link would require carefully comparing patients who take gabapentin exactly as prescribed with those who do not use the drug at all. Despite this, he highlighted that it is still important for patients and healthcare providers to be aware of potential cognitive risks associated with long-term gabapentin use.
Regarding clinical practice, Eghrari advised physicians who prescribe gabapentin for chronic pain to regularly assess their patients’ cognitive function during follow-up visits. He also encouraged patients to report any changes in memory, confusion, or slower thinking to their healthcare providers promptly.
Eghrari added:
“We hope to continue this research to determine whether a true causal link exists between gabapentin use and cognitive impairment. Additionally, we plan to study the underlying mechanisms to better understand how the drug may affect brain function.”