Popular back pain medication linked to brain health risks in some patients

A painkiller used for lower back pain could be linked to a higher risk of dementia and mild cognitive impairment (MCI), according to new research.

The study, published online in the journal Regional Anesthesia & Pain Medicine, found that groups previously considered too young to develop the conditions faced more than twice the risk when taking gabapentin.

"Our findings indicate an association between gabapentin prescription and dementia or cognitive impairment within 10 years," the research team stated in a press release.

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The drug has become increasingly popular for treating chronic pain, especially neuropathic (nerve) pain, the researchers noted in a press release.

Gabapentin — which is also used to control seizures, according to Cleveland Clinic — has relatively low addictive potential compared to traditional opioids.

Recent research has sparked new concerns over its side effects, including a possible association with neurodegeneration.

Previous findings could not confirm a specific link, especially regarding whether certain age groups are more vulnerable.

In the latest study, researchers collected data from TriNetX, a health research network containing electronic health records from 68 healthcare organizations across the U.S.

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Examining anonymous records of adult patients, the team looked at groups who had been prescribed gabapentin for chronic lower back pain between 2004 and 2024 and compared them to people who hadn’t received the drug. There were a total of 26,414 individuals in each group.

The researchers accounted for factors like demographics, co-existing conditions and the use of other pain-relieving drugs.

Patients who had received six or more gabapentin prescriptions were 29% more likely to be diagnosed with dementia and 85% more likely to be diagnosed with MCI within 10 years of their initial pain diagnosis, the study found.

Looking at specific age groups, people between 18 and 64 years old who received the drug were more than twice as likely to develop either condition than those who hadn’t been prescribed gabapentin.

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While there was no heightened risk among those aged 18 to 34 who were prescribed the drug, the risk of dementia more than doubled (and the risk of MCI more than tripled) among 35- to 49-year-olds.

Researchers observed a similar pattern among 50- to 64-year-olds.

Risks rose with prescription frequency: Patients with 12 or more prescriptions were 40% more likely to develop dementia and 65% more likely to develop MCI than those who were prescribed gabapentin between three and 11 times. 

The study did have some limitations. As this was an observational study, no firm conclusions can be drawn about cause and effect, the researchers noted.

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They also acknowledged that because the study was retrospective, they couldn’t account for dose or length of gabapentin use.

The results "support the need for close monitoring of adult patients prescribed gabapentin to assess for potential cognitive decline," the researchers added.