AnnaMaria
Millions of people struggling with chronic back pain rely on medication just to get through the day. But a major new American study has uncovered something few expected: one of the most commonly prescribed back-pain drugs may be quietly increasing the risk of dementia and long-term cognitive decline. And the danger appears to be even greater for younger adults who would normally be considered far from dementia age.
Researchers at Case Western Reserve University, together with dozens of medical institutions across the United States, analyzed an enormous dataset of patient records to investigate the long-term impact of gabapentin, a drug widely used for nerve and back pain. Their findings have caused concern among neurologists, pain specialists, and primary care physicians.
The study examined 26,414 adults who were prescribed gabapentin for chronic low-back pain and compared them with a carefully matched group of patients suffering the same type of pain but not taking the drug. In total, the data came from 68 health systems across the country, making this one of the largest analyses of gabapentin’s long-term cognitive effects ever conducted.
The results were striking. Adults who received six or more prescriptions of gabapentin were 29% more likely to be diagnosed with dementia within ten years. Even more alarming, their risk of developing mild cognitive impairment—a condition often considered an early step toward dementia—was 85% higher. These numbers raised immediate questions about whether a drug many patients consider relatively safe might have long-term consequences that were previously underestimated.
What surprised the researchers even more was the age group most affected. Although dementia is typically associated with older age, the sharpest increases in risk were seen in adults between 35 and 49. Those in this age bracket already dealing with chronic pain saw their risk of dementia more than double when taking gabapentin. Their risk of mild cognitive impairment more than tripled. Adults aged 50 to 64 showed similarly elevated risks, while the youngest adults—those between 18 and 34—did not appear to have an increased risk in this study.
The research team, whose work was published in the journal Regional Anesthesia & Pain Medicine, emphasized that while the study revealed a powerful association, it did not prove that gabapentin directly causes dementia. The study was observational, which means it shows correlation rather than cause and effect. But the size of the dataset and the strength of the findings led the authors to recommend increased monitoring of adults who use gabapentin long-term. They urged physicians to be alert to possible signs of cognitive decline, especially in patients receiving repeated prescriptions over several years.
Gabapentin has known side effects, including dizziness, fatigue, swelling, and dry mouth. Previous studies have also linked it to breathing issues and balance problems in older adults. But the new study revealed a dose-related pattern: the more gabapentin a patient took, the higher the cognitive risk became. People who received 12 or more prescriptions saw their risk of dementia rise by 40%, and their risk of mild cognitive impairment increase by 65%. These effects remained significant even after adjusting for variables such as other medications, underlying health conditions, and demographic factors.
Gabapentin has been on the market since the early 1990s, originally developed to treat epilepsy. Over the years, it became widely used for nerve pain, restless legs syndrome, shingles pain, and chronic back pain. For many doctors, gabapentin became a safer alternative to opioids during the opioid crisis, contributing to its dramatic increase in nationwide prescriptions. Today, millions of Americans take the drug, often for years at a time.
However, researchers have started to question whether gabapentin is always the right choice for chronic back pain, especially when mobility limitations—a known dementia risk factor—are part of a patient’s condition. In this study, though, gabapentin users were matched with others experiencing similar mobility issues who did not take the drug. This suggests that limited movement alone cannot explain the cognitive differences.
The findings do not mean people should immediately stop taking their medication. Experts advise patients to avoid abrupt discontinuation because gabapentin withdrawal can cause physical and psychological symptoms. Instead, physicians recommend approaching these results with measured awareness. For patients who rely on the drug for pain management, the focus should be on regular cognitive check-ins, discussing risks during medical appointments, and considering alternative treatments when appropriate.
Neurologists emphasize that while gabapentin remains safer than many high-risk pain medications, especially opioids, the long-term effects of chronic use need to be better understood. The new study adds to a growing body of evidence suggesting that long-term gabapentin therapy should be approached more cautiously, especially for younger adults who may unknowingly increase their future risk of neurological decline.
Researchers from Case Western Reserve University summarized their findings with a clear message: there is a notable association between gabapentin use and the risk of dementia or cognitive impairment within a ten-year period. Given how many people depend on this medication every day, this is a signal worth paying attention to—not with panic, but with informed awareness and proactive health management.
