Gabapentin is an FDA-approved anticonvulsant used for seizures and nerve pain, but it’s also prescribed “off-label” for conditions like fibromyalgia, insomnia, and anxiety. It’s considered safer than opioids, though it can cause dizziness, nausea, memory loss, and speech issues.

A new study in Regional Anesthesia & Pain Medicine examined over 26,000 adults with chronic pain. Researchers compared gabapentin users to non-users across age groups and followed them for a decade. They found that people with six or more prescriptions had a 29% higher risk of dementia and 85% higher risk of mild cognitive impairment (MCI).

“The significance of this finding is an association between gabapentin prescription and dementia on a nationwide level,” said lead author Nafis B. Eghrari. Surprisingly, the strongest risks were in ages 35–49, where dementia risk doubled and MCI risk tripled.

Experts caution against over-interpreting the results. “People with chronic pain requiring gabapentin may have been less physically active, which is a known risk factor,” noted Tara Spires-Jones. Others stressed that dosage, treatment length, and other medications were not considered.

Doctors advise caution: “Physicians prescribing gabapentin for chronic pain [should] perform cognitive exams on a regular basis,” said Eghrari. Patients should not stop the drug suddenly without medical supervision.