A popular pain medication, gabapentin, often used as a safer alternative to opioids, is now being linked to a higher risk of dementia and mild cognitive impairment (MCI), according to a new study.
Published in the journal Regional Anesthesia & Pain Medicine, the study found that adults prescribed gabapentin frequently were significantly more likely to develop cognitive problems within 10 years of their initial diagnosis for chronic pain.
Researchers reviewed tens of thousands of anonymized electronic health records from 68 U.S. healthcare organizations, provided by TriNetX, a large health data research network. They discovered that individuals who received six or more gabapentin prescriptions were 29% more likely to develop dementia and 85% more likely to develop MCI compared to those with fewer prescriptions.
Younger Adults Also at Risk
While the risk was not found in younger users aged 18 to 34, the study showed a sharp increase among those aged 35 to 49. In that age group, dementia risk more than doubled, and the likelihood of developing MCI more than tripled. A similar trend appeared in patients aged 50 to 64.
The number of prescriptions was another key factor. Those who had 12 or more gabapentin prescriptions were 40% more likely to be diagnosed with dementia and 65% more likely to develop MCI than those who had between 3 and 11 prescriptions.
Reevaluating a “Safer” Option
Gabapentin has long been viewed as a safer option for treating chronic pain, especially low back pain, because it has a lower potential for addiction compared to opioids. However, the new findings challenge that assumption, highlighting possible long-term effects on brain health.
“This is interesting,” said Prof Sir John Hardy of the UK Dementia Research Institute at University College London, “but we have to be cautious. These kinds of studies can sometimes show misleading results. The effects might be short-term and not actually related to diseases like dementia.”
The study’s authors also noted that it was observational and retrospective, meaning they could not determine the exact dosage or how long patients took gabapentin. As a result, they cannot confirm that gabapentin directly causes dementia or cognitive decline.
Call for Closer Monitoring
Despite these limitations, researchers concluded that frequent prescriptions of gabapentin are associated with an increased risk of developing dementia or MCI. They recommended closer monitoring of adults who are regularly prescribed this medication.
“Our findings suggest a possible link between gabapentin use and cognitive decline,” the study stated. “The more often gabapentin was prescribed, the greater the risk.”
Dr. Leah Mursaleen, Head of Clinical Research at Alzheimer’s Research UK, emphasized that more evidence is needed before making firm conclusions.
“This study only shows a link, not proof that gabapentin causes dementia or MCI,” she said. “We don’t know how much medication people took or how long they were on it.”
Dr. Mursaleen also noted that since the study only looked at patients with chronic pain, other factors could have influenced the results. “Earlier research on people using gabapentin for seizures, for example, did not find the same risk.”
Advice for Patients
Managing chronic pain remains essential. Experts urge patients not to stop taking prescribed medication without speaking to their doctor.
“Anyone concerned about the effects of gabapentin should talk to their healthcare provider,” said Dr. Mursaleen. “Your doctor can help you weigh the benefits and risks and decide what’s best for your treatment.”
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