Gabapentin Linked to Increased Dementia Risk: A Cautionary Analysis

Recent research has unveiled a concerning association between the anticonvulsant medication gabapentin, commonly prescribed for chronic back pain, and an elevated risk of mild cognitive impairment (MCI) and dementia. The study led by Dr. Nafis Eghrari from Case Western Reserve University School of Medicine, published on July 10, 2025, in the journal *Regional Anesthesia & Pain Management*, highlights that adults using gabapentin exhibited a 29% higher risk of developing dementia and an 85% increased risk of MCI within a decade, compared to those not prescribed the drug.

The investigation utilized the TriNetX national database, evaluating a cohort of over 26,000 gabapentin users matched against non-users. It was revealed that the risks associated with gabapentin corresponded with age demographics, with elderly patients (age 65 and older) facing a risk ratio (RR) of 1.28 for dementia and 1.53 for MCI. Meanwhile, nonelderly users (ages 18-64) showed an even more alarming trend with an RR of 2.10 for dementia and 2.50 for MCI.

Despite the compelling data, experts urge caution in drawing definitive conclusions. Dr. Martin Prince, a professor of epidemiological psychiatry at King’s College London, emphasized the potential for confounding factors and reverse causality, suggesting that the observed effects may not be directly attributable to gabapentin. Dr. Tara Spires-Jones, director at the Centre for Discovery Brain Sciences at the University of Edinburgh, pointed out that the study did not account for varying levels of physical activity among patients, which is a recognized risk factor for dementia.

Moreover, Professor Sir John Hardy from the UK Dementia Research Institute noted that findings from such studies could be artefactual, arising from temporary effects on cognitive performance rather than long-term implications on dementia development. Ian Maidment, a professor in clinical pharmacy at Aston University, remarked that the current study did not control for treatment duration or gabapentin dosage, raising questions about the reliability of the findings. He concluded that the evidence linking gabapentin to dementia remains inconclusive.

These findings could have significant implications for the millions of patients relying on gabapentin as a safer alternative to opioids for chronic pain management. As the medical community continues to scrutinize these associations, it is essential for healthcare providers to monitor patients on gabapentin for any signs of cognitive decline. The need for further research into this potential risk is crucial to ensure patient safety in pain management strategies.

In summary, while the data presents a troubling association between gabapentin use and increased dementia risk, the complexities of causation require further investigation. As such, both clinicians and patients must remain vigilant and informed about the potential cognitive consequences of long-term gabapentin use.