Fisher Center for Alzheimer’s Research – A popular pain reliever used to treat back pain and other conditions has been tied to a heightened risk for dementia, according to a new report.
Researchers found that adults who took the medication, gabapentin, to relieve persistent low back pain were significantly more likely to develop dementia or other cognitive problems than their peers with chronic back pain who were not given the drug.
For the study, researchers from Case Western Reserve University School of Medicine and other institutions analyzed electronic health records from 68 health care organizations across the United States.
They focused on 26,414 patients who had been prescribed gabapentin for persistent low back pain between 2004 and 2024 and compared them with an equal number of low-back-pain patients who had not received the drug, taking into consideration such factors as age, coexisting medical conditions and the use of other pain-relieving drugs.
They found that those who had received six or more prescriptions for gabapentin were 29 percent more likely to be diagnosed with Alzheimer’s disease or other forms of dementia within 10 years of their initial pain diagnosis than their peers who hadn’t taken the drug.
Those given gabapentin were also 85 percent more likely to be diagnosed with mild cognitive impairment, or MCI, a memory-impairing brain condition that often progresses to full-blown dementia.
The more gabapentin patients received, the higher their cognitive risks. Patients who had filled 12 or more prescriptions for gabapentin were 40 percent more likely to develop dementia and 65 percent more likely to develop MCI within 10 years than those who had received three to 11 prescriptions for the drug.
The drug also appeared to raise cognitive risks among younger adults who are not at high risk for dementia and similar conditions. The risk of dementia more than doubled among those aged 35 to 49 prescribed gabapentin, and the risk of MCI more than tripled in this age group. Similarly increased risks were observed in those aged 50 to 64. The findings were published in the journal Regional Anesthesia & Pain Medicine.
The study showed only an association between gabapentin use and brain impairments and cannot prove cause and effect. It is possible, for example, that people with chronic pain who are prescribed gabapentin for prolonged periods may be particularly immobile and unable to exercise, and lack of physical activity is a recognized risk factor for Alzheimer’s disease.
But the study was large, and the researchers matched chronic pain patients taking gabapentin with controls with similar physical limitations who were not taking the drug. Other studies have also raised possible concerns about gabapentin side effects.
Gabapentin was initially approved in 1993 by the U.S. Food and Drug Administration to manage seizures in people with epilepsy. Doctors have increasingly prescribed the drug in recent years to treat chronic pain and various nerve conditions, including post-shingles pain and restless legs syndrome, because it is considered less addictive than opioid pain relievers.
While more research is needed to confirm possible links between gabapentin and cognitive impairment, the authors caution, “Our results support the need for close monitoring of adult patients prescribed gabapentin to assess for potential cognitive decline.”
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Eric Schmidt, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Nafis B. Eghrari, Isabella H. Yazji, Bryan Yavari, et al: “Risk of dementia following gabapentin prescription in chronic low back pain patients.” Regional Anesthesia & Pain Medicine, July 10, 2025
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