A large medical records study published in the journal Regional Anesthesia & Pain Medicine has found that receiving six or more prescriptions of gabapentin for low back pain significantly increases the risk of developing dementia and mild cognitive impairment (MCI) by 29% and 85%, respectively.
Interestingly, this risk is more than twice as high in younger individuals, specifically those aged 18 to 64, who are typically not considered at risk for these conditions.
Gabapentin, unlike opioids, is less addictive and has gained popularity for treating chronic pain, particularly neuropathic pain, due to its potential neuroprotective properties, as noted by the researchers. However, emerging concerns are surfacing regarding its possible side effects, including links to neurodegeneration, although current findings have been inconsistent about which age groups might be at greater risk.
To investigate further, the researchers utilized real-time data from TriNetX, a health research network that collects electronic health records from 68 health organizations across the U.S.
They examined anonymized records of adult patients who were either prescribed gabapentin or not, with each group consisting of 26,414 individuals, over a period from 2004 to 2024, considering factors like demographics and comorbidities.
The study revealed that those receiving six or more prescriptions were 29% more likely to develop dementia and 85% more likely to be diagnosed with MCI within a decade of their initial diagnosis for pain.
Breaking it down by age, younger patients (18-64) prescribed gabapentin showed more than double the chance of developing either condition compared to those who weren’t prescribed the drug. For individuals aged 35-49, the risk of dementia more than doubled and for MCI, it tripled. A similar trend was seen in those aged 50-64.
Moreover, the frequency of prescriptions correlated with increased risks: those with 12 or more prescriptions had a 40% higher likelihood of developing dementia and a 65% higher likelihood of developing MCI compared to those prescribed the drug fewer times.
This is an observational study, and while it offers insights, it doesn’t establish cause and effect definitively. The researchers further recognize its retrospective nature, meaning they couldn’t account for dosage or duration of gabapentin usage.
Nonetheless, they conclude that “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.” They emphasize the importance of monitoring adults prescribed gabapentin for potential cognitive decline.
