Gabapentin is an FDA-approved prescription anticonvulsant primarily used to manage epileptic seizures and nerve-related pain. While originally developed for epilepsy, gabapentin has become widely prescribed for a variety of off-label uses. These include conditions such as fibromyalgia, sciatica, insomnia, anxiety disorders, hot flashes, and lower back pain. Its growing popularity can be attributed to its reputation as a less addictive alternative to opioids.

However, like all medications, gabapentin comes with potential side effects. Commonly reported issues include nausea, dizziness, fatigue, headaches, memory lapses, and difficulty with speech or concentration. But now, new research suggests that long-term use may carry a more serious risk: cognitive decline and even dementia.

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New Study Links Gabapentin Use to Dementia and Cognitive Impairment

A recent study published in the journal Regional Anesthesia & Pain Medicine has brought renewed attention to gabapentin’s long-term neurological effects. The research used data from TriNetX, a large federated health research network, to analyze the health records of more than 26,000 adults diagnosed with chronic pain conditions — including chronic lower back pain and lumbar radiculopathy.

Researchers compared this data to a control group of similar size that had not taken gabapentin. Participants were sorted into five age groups: 18–34, 35–49, 50–64, 65+, and 18–64 (general adult population). Over a follow-up period of ten years, researchers tracked how many individuals developed mild cognitive impairment (MCI), Alzheimer’s disease, or vascular dementia.

According to lead author Nafis B. Eghrari, a 4th-year medical student at Case Western Reserve University School of Medicine, the goal was to explore a knowledge gap:

“Currently, there is a discrepancy on whether taking gabapentin increases a patient’s risk for developing dementia,” Eghrari told Medical News Today. “Moreover, there lacks a strong understanding of how gabapentin impacts cognitive function and whether it contributes to neurodegenerative processes. Previous studies have shown mixed findings on this topic. Thus, we decided to explore this gap in the field.”

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What Did the Study Find?

The key finding: individuals who had six or more prescriptions of gabapentin showed a 29% increased risk of developing dementia and an 85% higher risk of MCI compared to those who did not take the drug.

Eghrari emphasized the importance of this association:

“The significance of this finding is an association between gabapentin prescription and dementia on a nationwide level. Though this does not imply causation, it certainly warrants further investigation into the drug’s long-term effects.”

One surprising result was the age group most at risk: individuals aged 35–49. This group had double the risk of developing dementia and triple the risk of developing MCI compared to the control group.

“We were surprised that the increased risk was so pronounced in a younger population,” Eghrari said. “Neurodegeneration is typically more common after age 65, so this trend in middle-aged adults was unexpected.”

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Study Limitations and Expert Criticism

Despite its scale and detailed data, the study is observational, meaning it cannot definitively establish cause and effect. Several medical experts have pointed out potential limitations.

Dr. Tara Spires-Jones, director of the Centre for Discovery Brain Sciences at the University of Edinburgh, noted that the study did not account for lifestyle factors, such as physical activity levels, which are known to influence dementia risk:

“People with chronic pain requiring gabapentin may have been less physically active, which is a known risk factor for developing dementia,” she told Medscape.

Meanwhile, Professor Ian Maidment of Aston University, England, highlighted that the analysis did not control for the length of treatment or specific dosages.

“Other similar recent studies have failed to find a link,” Maidment explained. “So the jury is still out on whether gabapentin actually causes dementia.”

Orthopedic spine surgeon Dr. Neel Anand, who was not involved in the research, emphasized the need for more rigorous clinical trials:

“To truly prove causation, you’d need a controlled study where participants are only taking gabapentin, and researchers confirm they’re taking it as prescribed,” Anand said. “Still, the possibility of cognitive decline is something patients and doctors should be aware of.”

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Main Takeaways for Patients and Doctors

While the findings are not conclusive, the study suggests greater caution is needed when prescribing gabapentin for long-term use, particularly in non-elderly adults.

Eghrari recommends that healthcare providers consider regular cognitive assessments for patients on long-term gabapentin therapy.

“I’d also advise patients to speak to their doctor if they notice any signs of cognitive decline, such as confusion, memory loss, or slowed thinking,” he added.

In addition to the cognitive risks, gabapentin can cause serious side effects including:

• Severe allergic reactions

• Behavioral or mood changes

• Suicidal ideation

• Jaundice (yellowing of the skin)

• Blood in the urine

Patients should never stop taking gabapentin abruptly, especially if they are using it to manage epilepsy. Stopping suddenly can lead to withdrawal symptoms or an increased risk of seizures. Always consult with a qualified healthcare professional before making changes to any medication regimen.

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What’s Next? Future Research Directions

The researchers hope to build on these findings with further studies that examine whether gabapentin directly contributes to neurodegenerative diseases, and if so, through what mechanisms.

“We plan to explore whether there is a true causative relationship between gabapentin and cognitive impairment,” said Eghrari. “We also want to investigate how the drug may influence brain function at the molecular level.”

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⚠️ Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor or a licensed medical professional before starting, stopping, or changing any prescribed treatment.