A commonly prescribed medication for lower back pain may be associated with a higher risk of dementia and mild cognitive impairment (MCI), according to new research.
The study, published in Regional Anesthesia & Pain Medicine, found that adults taking gabapentin were significantly more likely to experience cognitive decline within 10 years compared to those who weren’t prescribed the drug. The risk appeared to be highest among patients between the ages of 35 and 64.
Gabapentin Use Tied to Increased Cognitive Risk
“Our findings indicate an association between gabapentin prescription and dementia or cognitive impairment within 10 years,” the researchers stated in a press release.
Gabapentin, a drug originally developed to control seizures, has seen growing use in recent years to treat chronic nerve-related pain, particularly in place of opioids due to its lower addiction potential.
Researchers analyzed anonymized health data from 68 U.S. health care organizations via the TriNetX database. The study compared 26,414 patients who had been prescribed gabapentin between 2004 and 2024 with an equal number of patients who had not taken the drug. All participants had a diagnosis of chronic lower back pain.
Key Findings by Age Group and Prescription Frequency
After adjusting for demographics, co-existing medical conditions, and other medications, researchers found:
- Patients who received six or more gabapentin prescriptions were 29% more likely to be diagnosed with dementia and 85% more likely to be diagnosed with MCI within a decade.
- The risk was especially high among 35- to 49-year-olds, where the likelihood of dementia more than doubled and MCI more than tripled.
- For patients aged 50 to 64, the elevated risk followed a similar pattern.
- Younger adults (18–34) did not appear to face an increased risk.
- Those with 12 or more prescriptions were 40% more likely to develop dementia and 65% more likely to develop MCI compared to those with only 3–11 prescriptions.
Study Limitations and Next Steps
The study was observational, meaning it cannot establish a direct cause-and-effect relationship. Researchers also acknowledged that they could not account for dosage or treatment duration, as the study relied on retrospective health records.
Still, the findings raise concerns. “The results support the need for close monitoring of adult patients prescribed gabapentin to assess for potential cognitive decline,” the authors noted.
What Patients Should Know
Gabapentin continues to be widely used for a variety of conditions beyond back pain, including seizures and nerve damage. While this study doesn’t call for halting its use, it does suggest doctors should be more vigilant in tracking cognitive changes in patients taking the drug long-term.
