Common back-pain drug may be linked to higher dementia risk, large study finds

However, the findings do not prove that gabapentin causes dementia. The study was observational, meaning researchers examined patterns in existing medical records rather than randomly assigning patients to take the medication. Even though the analysis attempted to account for differences between the groups, other factors associated with chronic pain, medication use, or underlying health could still contribute to the results.

Younger adults showed a striking association

One of the most notable findings involved adults ages 18 to 64. Among non-elderly patients who received gabapentin, the researchers found more than twice the incidence of dementia compared with similar patients who did not receive the medication. The association with mild cognitive impairment was also more than twice as high. Specifically, the reported relative risks were 2.10 for dementia and 2.50 for MCI.

The researchers also observed a relationship with prescription frequency. Patients who received 12 or more prescriptions had higher rates of dementia and MCI than those who received three to 11 prescriptions. This pattern raises questions about whether longer or more frequent exposure could be relevant, although the study cannot establish that gabapentin itself is responsible.

Why gabapentin may affect thinking

Gabapentin is commonly used for nerve-related pain and was originally approved for partial seizures. It can affect the nervous system, and some patients may experience side effects such as drowsiness, dizziness, confusion, or problems with concentration. Those effects are different from dementia, however, and experiencing temporary cognitive side effects does not mean a person is developing dementia.

The new research is therefore better viewed as a signal that deserves further investigation, rather than evidence that gabapentin inevitably causes long-term cognitive decline.

Patients should not stop the medication on their own

For people currently taking gabapentin, the findings do not mean they should suddenly discontinue treatment. Gabapentin can be prescribed for several conditions, and stopping it abruptly—particularly after regular use—can create problems. Anyone concerned about memory, concentration, confusion, or other changes should discuss those symptoms and the risks and benefits of continuing treatment with their healthcare professional.

The study’s authors similarly called for closer monitoring of cognitive outcomes and additional research to determine whether the relationship is causal.

What the study really tells us

The research involved a large, nationally distributed medical-record database and found a statistically significant association between repeated gabapentin prescriptions and subsequent diagnoses of dementia or mild cognitive impairment. But an association is not the same thing as causation.

There is still an important unanswered question: Is gabapentin contributing to cognitive decline, or are other characteristics of patients with chronic pain helping explain the association?

Until stronger evidence—including studies designed to address these potential confounding factors—is available, gabapentin should not automatically be viewed as a cause of dementia. The findings do, however, give researchers another reason to investigate the medication’s potential long-term cognitive effects, particularly among people receiving repeated prescriptions.

Bottom line: The study raises a legitimate safety question, especially for people receiving gabapentin repeatedly, but it does not establish that the medication causes dementia. Anyone taking it should discuss individual risks, benefits, and any new cognitive symptoms with their healthcare professional rather than stopping treatment without medical guidance.