Popular back pain medication increases risk of dementia by 110 percent.
Gabapentin is a medication used to treat epilepsy. It can also be used to treat neuropathic pain (i.e., pain resulting from nerve damage) in adults, particularly diabetic polyneuropathy or post-herpetic neuralgia. In the United States, gabapentin is also commonly prescribed for chronic lower back pain (low back pain), regardless of whether neuropathy, or nerve damage, may be the cause.
There have been previous reports of a potential link between gabapentin and neurodegenerative processes in the brain , but they were not conclusive.
Researchers from Case Western Reserve University School of Medicine in Cleveland, Ohio, and other US centers used clinical data from nearly 53,000 US adults, available on the global TriNetX platform. Between 2004 and 2024, half of these patients were prescribed gabapentin for low back pain , while half were not. The analysis adjusted for demographics, comorbidities, and use of other pain medications.
They found that those who received at least six prescriptions for gabapentin had a 29 percent higher risk of being diagnosed with dementia within 10 years of their pain diagnosis and an 85 percent higher risk of being diagnosed with mild cognitive impairment (MCI), compared to the control group.
Importantly, in younger patients aged 18-64, the association between gabapentin use and the risk of cognitive impairment was even greater. The risk of dementia more than doubled (110%) and the risk of mild cognitive impairment 2.5-fold (150%) , compared to those not prescribed the drug.
Furthermore, the risk increased with the number of gabapentin prescriptions. Patients with 12 or more prescriptions had a 40 percent higher risk for dementia and a 65 percent higher risk for mild cognitive impairment, compared with patients with 3 to 11 prescriptions.
The researchers emphasize that the study was observational in nature and therefore does not prove a cause-and-effect relationship. Furthermore, the authors were unable to determine either the dose of gabapentin or the period over which it was administered.
However, they believe that closer monitoring of adult patients prescribed gabapentin is necessary to assess potential cognitive impairment.
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