Gabapentin: Link to Side Effects and Dementia Risk?
Gabapentin is an FDA-approved prescription drug primarily used as an anticonvulsant to treat neuropathic pain and control seizures. However, it is also often prescribed off-label for pain relief or to treat fibromyalgia, sciatica, insomnia, anxiety, hot flashes, and low back pain. This medication is popular because it does not cause the severe addiction seen with opioids. Like any medication, gabapentin can cause side effects, including nausea, dizziness, fatigue, headache, memory impairment, and slurred speech.
However, a new study shows that people who received six or more prescriptions for gabapentin for lower back pain have a higher risk of mild cognitive impairment and dementia.
Can gabapentin increase the risk of dementia?
The study, published in the journal Regional Anesthesia & Pain Medicine , used data from the TriNetX health research network . Researchers analyzed data from more than 26,000 adults with chronic pain, chronic pain syndrome, chronic low back pain, or lumbar radiculopathy. The data were compared to a control group of the same number of participants not taking the medication. Participants were then divided into five age groups: 18-34 years, 35-49 years, 50-64 years, 65 years and older, and a general group of 18-64 years. The results were followed up 10 years later to determine how many of them developed mild cognitive impairment (MCI), Alzheimer’s disease, or vascular dementia.
“There is currently controversy over whether gabapentin increases the risk of dementia in patients,” Nafis B. Eghrari, lead author of the study and a fourth-year medical student at Case Western Reserve University School of Medicine , told Medical News Today . “It is not well understood how gabapentin affects cognitive function and whether it may contribute to neurodegenerative processes. Previous studies have shown conflicting results, so we decided to fill this gap.”
The results showed that participants who received six or more gabapentin prescriptions had a 29% increased risk of dementia and an 85% increased risk of MCI . “The significance of this finding is that it establishes a link between gabapentin prescriptions and dementia nationwide,” Eghrari said. “This does not prove a cause-and-effect relationship, but warrants further study of the drug’s long-term effects.”
Additionally, the team found that the risk was highest among those aged 35-49, with a two-fold increase in dementia and a three-fold increase in MCI. Eghrari said he was surprised to find that the greatest increase in risk was in the non-elderly population, with those over 65 generally at higher risk for neurodegeneration.
Limitations and criticisms of the study
This observational study has some limitations. One of these is the lack of information on other concurrent diagnoses or treatments of the participants. Furthermore, many factors influence the risk of dementia, making it impossible to determine the exact cause, especially in studies with large databases.
“One very important factor that hasn’t been studied yet is physical activity level,” Professor Tara Spiers-Jones, director of the Brain Sciences Research Centre at the University of Edinburgh, told Medscape . “People with chronic pain taking gabapentin may have been less physically active, which is a known risk factor for dementia.”
Ian Maidmont, professor of clinical pharmacy at Aston University in Birmingham, also notes that the analysis did not take into account treatment duration or dosage. He points out that other similar studies have not found a link. “So it’s still unclear whether gabapentin causes dementia,” he adds.
Dr. Neil Anand, a board-certified orthopedic surgeon who was not involved in the study, points out that the only way to prove a causal link is to compare patients taking only the drug to a similar group not taking it, ensuring they were taking it correctly. He concludes, however, “At least we can be aware of the potential side effects of prolonged use of gabapentin.”
Main conclusions
Despite the limitations of the observational study, the authors recommend caution when taking this drug.
“It is clinically important that physicians prescribing gabapentin for chronic pain routinely perform cognitive assessments in their patients,” says Eghrari. He also advises physicians to be cautious. “I recommend that patients taking this medication notify their physician immediately if they experience cognitive impairments such as confusion, memory impairment, or slowed thinking.”
According to the Cleveland Clinic, other serious side effects to watch for include allergic reactions, mood and behavior changes, suicidal thoughts, jaundice, and blood in the urine. Patients should not stop gabapentin treatment or change its dosage without consulting a doctor. Abrupt discontinuation can lead to complications, such as an increased risk of seizures in people being treated for epilepsy.
Eghrari concludes: “We hope to continue this research and determine if there is a real cause-and-effect relationship between gabapentin and cognitive impairment. We also plan to study the mechanisms by which the drug might affect brain function.”
This article is provided for informational purposes only. Avoid self-medication and always consult a qualified healthcare professional before applying any information contained in this text. The editorial team does not guarantee any results and disclaims any liability for any damage resulting from its use.
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