The Hidden Link? New Research Suggests Gabapentin Use May Be Connected to Increased Dementia Risk
In the world of modern medicine, few drugs have enjoyed the widespread acceptance and clinical reliance that gabapentin has. Originally hailed as a breakthrough for nerve-related pain and epilepsy, this medication has found its way into millions of prescriptions across the globe. But a new study from Case Western Reserve University in Ohio is now raising important questions — suggesting that long-term or repeated use of gabapentin might carry a hidden price: a higher risk of developing dementia later in life.
For decades, gabapentin — often sold under the brand name Neurontin — has been prescribed for a variety of conditions. It is one of the go-to options for managing neuropathic pain, restless leg syndrome, and even anxiety disorders. Patients who suffer from persistent back pain, nerve injuries, or fibromyalgia often describe it as a “lifesaver,” a drug that helped them regain normal life after years of suffering. However, new findings are prompting the medical community to look deeper at what happens when this medication is used for years, or even decades.
A Study That Sparked Concern
The research, published in Regional Anesthesia & Pain Medicine, analyzed data from more than 26,000 patients in the United States. All of them had been diagnosed with chronic pain, and many were prescribed gabapentin repeatedly over time. What the team found sent ripples through the scientific community.
Patients who had been prescribed gabapentin at least six times were 29% more likely to develop dementia within a decade than those who had not used it. Even more concerning, those who received higher numbers of prescriptions — twelve or more — faced an even steeper increase, with a 40% higher likelihood of developing dementia and a 65% higher chance of experiencing mild cognitive impairment (MCI), a known precursor to dementia.
These are not small numbers. While the study does not prove that gabapentin directly causes dementia, it points toward a correlation strong enough to warrant further scrutiny.
Understanding How Gabapentin Works
Gabapentin belongs to a class of medications designed to calm overactive nerve activity in the brain and spinal cord. It does so by interacting with the gamma-aminobutyric acid (GABA) system — the body’s natural calming mechanism. Essentially, it slows down electrical impulses that can lead to pain, seizures, or discomfort.
This mechanism, while therapeutic for nerve disorders, may also influence other parts of the brain over time. Researchers have long speculated that altering GABA function chronically could affect memory, concentration, and other cognitive processes. However, until recently, large-scale human data connecting gabapentin use to dementia risk had been lacking.
A Drug That Became a Global Phenomenon
The story of gabapentin’s rise is a fascinating one. Approved in the early 1990s, the drug was initially intended to treat epilepsy. But as time went on, doctors began to discover its powerful ability to ease nerve-related pain — the kind that often doesn’t respond well to opioids or anti-inflammatories. By the 2010s, gabapentin had become one of the most prescribed medications in the world.
In the United States alone, more than 8 million prescriptions are filled every year. Across the Atlantic, the National Health Service (NHS) in England reports that over 799,000 patients received gabapentin in 2023–24. While that number reflects a slight drop from previous years, the drug remains a cornerstone of pain management, especially as doctors move away from opioids.
Yet, as prescribing increased, so did reports of potential side effects — from dizziness and confusion to problems with balance and focus. Many older patients and their caregivers began noticing subtle cognitive changes, which some dismissed as part of normal aging. Now, this new research adds weight to those anecdotal observations, suggesting there may be more to the story.
Breaking Down the Numbers
The Case Western team conducted a comprehensive analysis of health records spanning 20 years, from 2004 to 2024. Their goal was to identify long-term trends that might otherwise go unnoticed. The study focused on patients with chronic lower back pain — a population often treated with gabapentin as a safer alternative to opioids.
When researchers compared dementia rates between patients who used gabapentin and those who didn’t, they uncovered a striking pattern. Frequent users — those with multiple prescription renewals — consistently showed higher rates of dementia and mild cognitive impairment. The connection held even after adjusting for age, gender, and other health factors.
In particular, middle-aged adults seemed especially vulnerable. Patients aged 35 to 49 were found to have more than double the risk of dementia compared to those who never used the drug. For those over 50, the risk grew even more pronounced.
Why Might Gabapentin Affect the Brain?
The human brain relies on a delicate chemical balance to function optimally. When that balance is repeatedly influenced by drugs that alter neurotransmission, long-term effects can emerge. Gabapentin’s action on the GABA system can reduce nerve excitability, which is beneficial for pain — but may also dull certain cognitive pathways.
Some neuroscientists suggest that long-term use might subtly reduce brain plasticity — the brain’s ability to adapt, learn, and form new memories. Over years of use, these small changes could potentially accumulate, manifesting as memory problems or slowed thinking.
Still, experts caution against jumping to conclusions. The study does not prove that gabapentin causes dementia — only that it’s associated with a higher likelihood of being diagnosed with it. Chronic pain itself, for example, is a known contributor to cognitive decline, as are reduced mobility, sleep deprivation, and depression — all common in patients who take gabapentin.
The Debate Among Experts
Unsurprisingly, the study’s findings have sparked both concern and skepticism in the medical community.
Dr. Leah Mursaleen, Head of Clinical Research at Alzheimer’s Research UK, praised the study’s scale but emphasized that correlation does not equal causation. “It’s important to understand that this type of research can show patterns, not proof,” she said. “People taking gabapentin may already have other health conditions that increase dementia risk.”
Similarly, Professor Tara Spires-Jones of the University of Edinburgh pointed out that physical inactivity — common among chronic pain patients — may be a confounding factor. “If you’re in pain, you move less. And if you move less, your dementia risk goes up,” she noted. “So while the findings are valuable, we need further controlled studies to isolate what’s really going on.”
Implications for Patients and Doctors
For now, experts are urging caution rather than panic. Gabapentin remains an essential drug for millions of people. Discontinuing it suddenly can lead to withdrawal symptoms, seizures, or a resurgence of severe pain. Instead, doctors are being encouraged to adopt new best practices for long-term monitoring.
These include:
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Conducting baseline cognitive assessments before starting gabapentin.
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Scheduling regular follow-up evaluations to detect early cognitive changes.
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Discussing treatment duration and risk factors openly with patients.
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Considering collaborative care with neurologists for high-risk individuals.
Patients who are concerned should not stop taking their medication on their own. Instead, they should talk to their healthcare provider about possible dosage adjustments or alternative treatments.
The Bigger Picture: Dementia Prevention and Awareness
This study joins a growing body of research exploring how common medications may influence cognitive health. Over the past decade, scientists have linked several drug classes — including certain sleep aids, anticholinergic drugs, and benzodiazepines — to increased dementia risk with long-term use. Gabapentin now joins that list of drugs under scrutiny.
At the same time, researchers are learning more about how dementia develops and how it might be prevented. Studies have shown that up to 40% of dementia cases could be prevented or delayed through modifiable lifestyle factors, including staying physically active, managing blood pressure, avoiding smoking, and maintaining strong social connections.
That perspective is vital. Even if gabapentin does contribute to cognitive risk, the overall picture of brain health depends on many factors — genetics, lifestyle, other medications, and overall wellness.
What Comes Next for Research
The Case Western team has called for further investigation. Future studies will likely include:
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Prospective clinical trials with control groups.
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Mechanistic studies exploring how gabapentin interacts with brain chemistry.
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Population-based comparisons across different health conditions, not just chronic pain.
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Long-term cognitive tracking using brain imaging and neuropsychological testing.
Such research will help determine whether gabapentin directly contributes to dementia or merely appears alongside it in populations already at risk.
Conclusion: A Call for Balance and Vigilance
Gabapentin has undeniably improved the lives of countless people living with chronic pain and neurological disorders. For many, it is the only drug that makes daily life bearable. But as science continues to uncover potential long-term effects, it becomes increasingly clear that even trusted medications deserve ongoing scrutiny.
The takeaway from this new study is not fear — but awareness. Awareness that long-term use of any neurological drug should be closely monitored. Awareness that cognitive health must remain a top priority, especially for patients already managing complex medical conditions. And awareness that open communication between doctor and patient can make all the difference.
As the medical community awaits more definitive answers, one message stands out: patients should never stop their medication without professional guidance, but they should feel empowered to ask questions, request evaluations, and take an active role in protecting their brain health for the future.
