Dementia develops when brain cells are damaged and can no longer communicate, leading to brain shrinkage. Causes include genetics, aging, lifestyle, and other health conditions.

A new study in Regional Anesthesia & Pain Medicine explored links between gabapentin and dementia. Gabapentin, an FDA-approved drug for nerve pain and seizures, is also prescribed off-label for fibromyalgia, insomnia, anxiety, and back pain. It’s often preferred as a “less addictive alternative,” but side effects include “nausea, dizziness, fatigue, headaches, memory problems, and speech difficulties.”

Researchers analyzed data from over 26,000 adults with chronic pain. Compared to those not taking it, people with six or more gabapentin prescriptions had a “29% higher risk of dementia and an 85% higher risk of mild cognitive impairment.” The effect was strongest in ages 35–49, where “dementia risk doubled and MCI risk tripled.”

However, experts stressed limits. “The jury is out on whether gabapentin causes dementia,” said pharmacy professor Ian Maidment. Others noted the study didn’t account for exercise, dosage, or other health factors, all of which affect dementia risk.

Lead author Nafis B. Eghrari advised, “physicians prescribing gabapentin for chronic pain perform cognitive exams on a regular basis” and urged patients to report memory or thinking changes.