Could Gabapentin for Back Pain Raise Dementia Risk?

For millions living with chronic lower back pain, gabapentin has been a trusted ally—offering relief without the high addiction risk of opioids. But new research is raising important questions about this common medication’s long-term impact on cognitive health.

Key Findings from a Landmark Study

Researchers from Case Western Reserve University, Arizona State University, and MetroHealth Medical Center delved into medical records from over 26,000 adults with chronic lower back pain. 

Their goal? To examine if repeated gabapentin prescriptions were linked to a higher risk of developing dementia or mild cognitive impairment (MCI).

• Heightened Risk: Patients with six or more gabapentin prescriptions were 29% more likely to develop dementia and 85% more likely to experience MCI within ten years.
  
  
• Younger Adults at Greater Risk: The association was particularly pronounced among those aged 35–49.
  
  
• Prescription Count Matters: The more gabapentin prescriptions filled, the higher the risk observed.

Understanding Gabapentin

Known by brand names like Neurontin, gabapentin is widely prescribed for nerve pain and epilepsy. Its popularity surged as doctors sought alternatives to opioids for chronic pain. However, gabapentin is not free from side effects, which can include mood changes and, rarely, allergic reactions.

Why This Study Stands Out

The strength of this research lies in its large sample size and focus on a specific patient group. Importantly, the findings apply to those with chronic lower back pain and may not extend to people taking gabapentin for epilepsy or other conditions. Earlier studies on epilepsy patients have not shown similar links, highlighting the need for context-specific analysis.

• Mixed Evidence: Prior research has produced conflicting results regarding gabapentin’s cognitive effects.
  
  
• Potential Unique Interactions: The combination of chronic back pain, related inflammation, and gabapentin might uniquely influence dementia risk for these patients.

Possible Brain Effects

Gabapentin works by quieting certain neural communication pathways, reducing pain and seizure risk. Some experts worry this mechanism might also disrupt brain function in ways that could impair cognition. While this study adds to those concerns, it does not prove gabapentin directly causes dementia.

What Should Patients and Doctors Do?

In light of these findings, the researchers urge healthcare providers to monitor cognitive health in patients prescribed gabapentin, especially those with chronic back pain. While gabapentin remains less addictive than opioids, awareness of potential cognitive side effects is crucial. Patients should always consult their doctor before making any changes to their medication regimen.

The Road Ahead: More Questions Than Answers

Dementia is a complex condition with many contributing factors. Determining the exact role of gabapentin will require further research. The authors hope their work stimulates deeper investigation into how chronic pain treatments may affect long-term brain health.

Takeaway

If you or a loved one relies on gabapentin for chronic back pain, stay informed and maintain open communication with your healthcare team. While the medication offers important benefits, careful monitoring can help safeguard cognitive well-being for the future.

Source: ScienceAlert, David Nield, 17 July 2025