Introduction to Gabapentin

Gabapentin is a popular nerve pain drug often prescribed to individuals suffering from low-back issues and other types of persistent neurological pain. It works by blocking pain signals to the brain and mediating its electrical activity. Although its exact mechanism is not fully understood, gabapentin is preferred over opioids for treating chronic pain due to its low risk of addiction.

The Study and Its Findings

Researchers from Case Western Reserve University School of Medicine and Arizona State University conducted a study to investigate the long-term effects of gabapentin. They analyzed data from approximately 26,000 patients with chronic low-back pain who were prescribed gabapentin, and another 26,000 who were not. The data, spanning from 2004 to 2024, was obtained from TriNetX, a real-time data repository provided by 68 US-based health organizations.

Key Discoveries

After adjusting for demographics, co-existing conditions, and the use of other painkillers, the researchers found a significant link between gabapentin use and impaired mental health. Patients who filled six or more gabapentin prescriptions were 29% more likely to be diagnosed with dementia and 85% more likely to be diagnosed with mild cognitive impairment (MCI) within 10 years of their initial pain diagnosis.

Age-Specific Risks

The study also revealed that the risk of dementia and MCI varied by age. Adults aged 35-49 who were prescribed gabapentin had double the risk of dementia and triple the risk of MCI compared to those in the same age group who did not take the drug. Furthermore, the longer an individual took gabapentin, the higher their risk of developing dementia or MCI. Those who filled more than 12 prescriptions were 40% more likely to develop dementia and 65% more likely to develop MCI than those who filled between three and 11 prescriptions.

Conclusion

While the study does not establish a definitive cause-and-effect link between gabapentin and dementia, the findings suggest a significant association between the two. The researchers emphasize the need for close monitoring of adult patients prescribed gabapentin to assess for potential cognitive decline. As with any medication, it is crucial to weigh the benefits of gabapentin against its potential risks and to explore alternative treatment options when possible. The study’s results have been published in the journal Regional Anesthesia & Pain Medicine, contributing to the ongoing discussion about the long-term effects of gabapentin and the importance of responsible prescribing practices.