Common Back-Pain Drug May Be Linked to Higher Dementia Risk, Large Study Finds
A widely prescribed medication used to treat chronic lower back pain may be associated with an increased risk of dementia and cognitive decline, according to new research that has captured the attention of doctors, pharmacists, and patients alike.
Published in the Regional Anesthesia & Pain Medicine journal, this large observational study suggests that repeated prescriptions of the drug gabapentin — often perceived as a safer alternative to opioids for chronic pain — are linked with a higher likelihood of developing dementia and mild cognitive impairment (MCI) over time.
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What the Study Found
Researchers analyzed electronic health records of tens of thousands of adults diagnosed with chronic low back pain. They compared patients who had been prescribed gabapentin repeatedly with those who had not. The key findings include:
People with six or more gabapentin prescriptions were about 29% more likely to receive a dementia diagnosis within 10 years than those who never used the drug.
These same patients were about 85% more likely to develop mild cognitive impairment — an early sign of dementia.
Among people aged 35–64, the risk of both dementia and MCI was more than doubled compared with similar patients who were not prescribed gabapentin.
Higher frequency of prescriptions correlated with even greater risks, with those receiving 12 or more prescriptions showing a larger association with cognitive decline.
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This large dataset came from a U.S. health-records network, allowing researchers to match patients by age, sex, existing medical conditions, and other medications.
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What Gabapentin Is — and Why It’s Used
Gabapentin (brand name Neurontin among others) was originally approved for seizure control and nerve pain after shingles. However, it is now widely used “off-label” for a variety of chronic pain conditions, including back pain. Because it isn’t an opioid and is generally perceived as less addictive, its use has grown rapidly in recent years.
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Experts Notes: Association Isn’t Proof of Cause
It’s critical to understand what this study does — and doesn’t — show. Because it is observational (looking at real-world medical records), the research cannot confirm that gabapentin directly causes dementia. There could be other factors at play — for example, people with more severe pain may use the drug more and also experience lifestyle changes (like less physical activity) that affect brain health.
Centre de Médias Scientifiques
Dr. Leah Mursaleen, Head of Clinical Research at Alzheimer’s Research UK, emphasized that while the association is noteworthy, it doesn’t prove cause and effect — and many dementia risk factors are influenced by lifestyle, genetics, and overall health.
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Why This Matters
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