Popular painkiller may be linked to higher risk of dementia

Gabapentin, a drug used to treat epilepsy and neuropathic pain, may be linked to an increased risk of dementia and mild cognitive impairment, according to a large observational study conducted in the US and published in the journal Regional Anesthesia & Pain Medicine. Researchers are calling for closer monitoring of patients taking the drug.

Gabapentin is a drug commonly used to treat epilepsy and neuropathic pain, such as diabetic polyneuropathy and postherpetic neuralgia. In the United States, it is also prescribed to patients with chronic lower back pain—even if they do not have confirmed nerve damage.

Although gabapentin's effectiveness in relieving pain is well-known, questions are increasingly being raised about its potential impact on brain function. In a recent study, researchers indicate a significant link between the drug's use and the risk of cognitive decline, including dementia.

Researchers from Case Western Reserve University School of Medicine in Cleveland and other American centers analyzed data from nearly 53,000 adult patients in the US, available on the international TriNetX platform. Half of them were taking gabapentin for low back pain, while the other half were not.

The results showed that people who received at least six prescriptions for gabapentin had a 29% higher risk of being diagnosed with dementia within 10 years of their pain diagnosis. For mild cognitive impairment (MCI), the risk was as much as 85% higher than for patients who were not prescribed the medication.

The results for younger adults were also surprising. Among those aged 18–64, the risk of being diagnosed with dementia more than doubled— by a staggering 110% . The risk of mild cognitive impairment was even more pronounced, occurring 150% more often than in the control group.

The risk also increased with the number of prescriptions. Patients who received 12 or more prescriptions had a 40% higher risk of dementia and a 65% higher risk of MCI than those who took the drug in lower doses (3–11 prescriptions).

The study's authors emphasize that it is observational in nature, meaning it does not prove a direct effect of gabapentin on the development of dementia. The exact doses of the drug taken or the duration of treatment were also unknown.

Still, the results are so concerning that the researchers suggest strengthening patient surveillance. "They believe it is necessary to closely monitor adult patients prescribed gabapentin to assess for potential cognitive impairment," the publication states.