Dementia Diagnoses Rise in Adults Prescribed With Common Pain Drug

A commonly prescribed pain medication—gabapentin—often considered a safer alternative to opioids for those who suffer from low back pain is now under scrutiny after being linked to increased risks of dementia and mild cognitive impairment (MCI).

According to a large-scale observational study published in the journal Regional Anesthesia & Pain Medicine, patients who received frequent gabapentin prescriptions were significantly more likely to develop dementia and/or MCI.

Researchers analyzed anonymized medical records from tens of thousands of Americans sourced from TriNetX, a federated health research network with electronic health records from 68 healthcare organizations across the country.

They found that patients whom had received six or more gabapentin prescriptions were 29 percent more likely to be diagnosed with dementia and 85 percent more likely to be diagnosed with MCI within 10 years of their initial pain diagnosis.

Surprisingly, risks were higher among those who are usually considered too young to be affected by these conditions.

While no increased risk was found in users aged 18 to 34, for those aged 35 to 49, dementia risk more than doubled, and MCI risk more than tripled. A similar risk pattern was observed among 50–64 year olds.

Prescription frequency also played a main role, regardless of the patient's age. Those with 12 or more gabapentin prescriptions were 40 percent more likely to develop dementia and 65 percent more likely to develop MCI, compared to those with 3 to 11 prescriptions.

Thanks to its low addictive potential, gabapentin is usually seen as a safer option to opioids, however, the new findings raise concerns on its potential side effects on brain health.

Prof Sir John Hardy, Group Leader at the UK Dementia Research Institute at UCL, said: "While this is interesting, one has to worry that these types of findings are artefactual and result (for example) from a marginal acute effect on cognitive performance rather than effects on the underlying disease."

The researchers acknowledged that because the study was observational and retrospective, meaning they weren't able to account for dose or length of gabapentin use, they couldn't draw a firm conclusion on cause and effect.

Nevertheless, they concluded: "Our findings indicate an association between gabapentin prescription and dementia or cognitive impairment within 10 years. Moreover, increased gabapentin prescription frequency correlated with dementia incidence."

"Our results support the need for close monitoring of adult patients prescribed gabapentin to assess for potential cognitive decline."

Dr Leah Mursaleen, Head of Clinical Research at Alzheimer's Research UK, said that this study only shows an association between gabapentin prescriptions and mild cognitive impairment or dementia, so they still don't know if the medication is directly causing the higher risk.

"Gabapentin dosage wasn't recorded, and there was no information on how long people were on the medication.

"Because this study only used health records of people with chronic pain, we cannot rule out other factors that might be influencing the findings. And previous studies looking at people prescribed gabapentin for other conditions like seizures, didn't show a link between the medication and higher dementia risk", she said.

She added that managing chronic pain is very important and anyone who has any concerns about the medication they are receiving, should consult to their doctor.

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Reference

Eghrari, N. B., Yazji, I. H., Yavari, B., Van Acker, G. M., & Kim, C. H. (2025). Risk of dementia following gabapentin prescription in chronic low back pain patients. Regional Anesthesia and Pain Medicine. https://doi.org/10.1136/rapm-2025-106577