Common back pain drug linked to increased dementia risk, major U.S. study finds

A widely used drug for back pain, gabapentin, may raise the risk of developing dementia and cognitive issues—especially in younger adults—according to a large U.S. study.

Gabapentin, a medication originally approved for epilepsy, has become a go-to prescription for chronic back and nerve pain. But a major new study suggests that long-term use could come with serious side effects, including memory loss and cognitive decline.

Researchers from Case Western Reserve University examined medical records from over 26,000 U.S. adults treated with gabapentin for low back pain. They compared these patients to a similar group with back pain who didn’t take the drug.

The findings, published in Regional Anesthesia & Pain Medicine, revealed troubling patterns: patients who received six or more prescriptions of gabapentin had a 29% higher risk of being diagnosed with dementia and an 85% greater chance of developing mild cognitive impairment (MCI) within 10 years.

Younger adults saw the most dramatic increases

Perhaps the most surprising discovery was how age affected risk. While dementia is usually associated with older age, the study found significant cognitive risks even for younger adults:

• Ages 35–49: More than double the risk of dementia and over triple the risk of MCI.
• Ages 50–64: Also showed elevated risks.
• Ages 18–34: No increased risk detected.

This suggests that the drug’s impact on the brain might start earlier than expected.

More prescriptions, higher risk

The study also revealed a dose-related trend: the more prescriptions a patient had, the greater the risk of cognitive decline.

• Patients with 12 or more prescriptions were 40% more likely to develop dementia.
• They were also 65% more likely to develop MCI.

These outcomes remained consistent regardless of age, health status, or other medications.

Is gabapentin causing dementia?

Not exactly. The researchers emphasize that their findings show a strong link—not a direct cause. This was an observational study, meaning it can highlight associations but cannot prove cause-and-effect.

They also didn’t have access to exact dosages or treatment lengths, which could further influence outcomes.

Still, the study’s massive data pool and consistent results raise important questions about how gabapentin affects the brain over time.

Gabapentin has been around since the 1990s and is widely prescribed for various conditions beyond epilepsy, including:

• Chronic back pain
• Nerve pain
• Post-shingles pain
• Restless legs syndrome

Doctors often favor it over opioids because it’s considered a safer, non-addictive alternative. However, its increasing long-term use—especially for back pain—has raised new concerns about overlooked side effects.

The researchers accounted for common risk factors like poor mobility, which is already tied to cognitive decline. But even after matching patients with similar conditions, the cognitive risks remained significantly higher in those taking gabapentin.

Experts stress that people taking gabapentin shouldn’t panic—but they should stay informed and talk to their doctors.

Here’s what patients and families can do:

• Schedule regular cognitive checkups
• Discuss any concerns with a healthcare provider
• Avoid long-term use unless necessary

Despite the concerns, gabapentin is still seen as safer than many opioid-based painkillers. But as its use grows, so does the need for awareness.

As the researchers noted: “Our findings indicate an association between gabapentin prescription and dementia or cognitive impairment within 10 years.”

If you or a loved one is using gabapentin for pain, this study is a reminder to check in regularly with your doctor and weigh the benefits against potential risks. With millions relying on this drug every year, understanding its long-term impact is more important than ever.