Pharmacology, the science of drugs and how they affect our bodies, is constantly evolving. It brings us new and improved treatments for everyday ailments while shedding fresh light on the long-term effects of medications used for decades.
A recent observational study published in Regional Anesthesia & Pain Medicine examined the potential downsides of gabapentin, a drug commonly prescribed for chronic pain. Researchers from the University School of Medicine in Cleveland, and Arizona State University analyzed health data from more than 25,000 adults and found that receiving six or more gabapentin prescriptions for low back pain correlated with a higher risk of developing dementia or mild cognitive impairment (MCI).
While the team emphasized that further investigation is needed to establish a causal relationship, they stressed in a press release that their findings “support the need for close monitoring of adult patients prescribed gabapentin to assess for potential cognitive decline.”
What Is the Drug Gabapentin?
Gabapentin has been used for over 20 years, particularly for nerve-related pain. Originally approved to treat partial seizures, it works by binding to voltage-gated calcium channels in the brain, reducing the release of specific neurotransmitters and dampening pain signals.
In 2016 alone, 64 million gabapentin prescriptions were dispensed in the U.S., making it the tenth most commonly prescribed drug. Its popularity stems partly from its relatively low addictive potential compared to opioids, and it has even been considered potentially neuroprotective in treating neuropathic pain.
However, concerns are now emerging about possible links to neurodegeneration. Research so far has been mixed, and there is no scientific consensus on whether gabapentin use contributes to cognitive decline in chronic pain patients.
Read More: Why Does Pain Hurt?
Dementia Risk Increases with Prescription Frequency
To explore these questions, the researchers analyzed data from TriNetX, a large health research network containing electronic health records from 68 healthcare organizations across the states. They looked at anonymized records of 26,414 adults diagnosed with chronic low back pain between 2004 and 2024, comparing those prescribed gabapentin to those who weren’t.
Their results indicated that adults prescribed gabapentin six times or more faced nearly a third higher risk of developing dementia and were close to twice as likely to experience mild cognitive impairment within 10 years of first reporting low back pain.
When breaking down the data by age, the study found that adults aged 18 to 64 who had been prescribed gabapentin were more than twice as likely to develop dementia or MCI compared to those who hadn’t received the drug. Breaking it down further, there was no heightened risk among 18 to 34 year olds to develop dementia. But for those aged 35 to 49, the risk of dementia more than doubled and the risk of MCI more than tripled, similar to patients aged 50 to 64.
The risks also increased with prescription frequency. Adults who received 12 or more prescriptions had a 40 percent greater risk to develop dementia and 65 percent more likely to show MCI compared to those fewer prescriptions.
Importance of Ongoing Research
These findings suggest that the risks of cognitive decline were more than twice as high in adults who are generally considered too young to develop these conditions.
However, the researchers emphasize that because this was an observational study, it cannot establish a direct cause-and-effect relationship. They also noted limitations, such as its retrospective design and lack of data on gabapentin dose or treatment duration.
Overall, they summarized in the news release: “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.”
For now, these findings serve as a reminder that pharmacology is an ever-evolving field, and even well-established treatments can reveal new effects over time, highlighting the importance of ongoing research and awareness.
This article is not offering medical advice and should be used for informational purposes only.
Read More: Antibiotics Might Not Be Connected to Cognitive Decline
Article Sources
Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:
Regional Anesthesia & Pain Medicine. Risk of dementia following gabapentin prescription in chronic low back pain patients
National Library of Medicine. Trends in Gabapentin Prescribing in a Commercially Insured U.S. Adult Population, 2009-2016
Having worked as a biomedical research assistant in labs across three countries, Jenny excels at translating complex scientific concepts – ranging from medical breakthroughs and pharmacological discoveries to the latest in nutrition – into engaging, accessible content. Her interests extend to topics such as human evolution, psychology, and quirky animal stories. When she’s not immersed in a popular science book, you’ll find her catching waves or cruising around Vancouver Island on her longboard.
