"Gabapentin, a drug used by millions of people for pain, may be linked to increased dementia risk."
I came across a post with this message in a Spanish support group. The author cited a study published in *Regional Anesthesia & Pain Medicine* suggesting a possible association between gabapentin use and cognitive decline. This naturally raises concern — especially since the medication is widely prescribed for neuropathic pain, nerve damage, and chronic spinal pain.
Unfortunately, the full article is not freely available, so only the abstract can be reviewed. I decided to look for more information and found another 2025 study — by Eghrari et al. — also published in *Regional Anesthesia & Pain Medicine*.
What exactly was analyzed?
The study included over 26,000 adult patients with chronic low back pain. The observation period lasted 10 years. It compared:
- Individuals taking gabapentin (at least 6 prescriptions)
- With those who were not taking it
The researchers analyzed the development of:
- Dementia
- Mild cognitive impairment (MCI)
Key findings
- Individuals taking gabapentin had a 29% higher risk of dementia diagnosis
- The risk of mild cognitive impairment was 85% higher
- In the 18–64 age group, the risk of dementia was more than 2 times higher
- The more prescriptions (≥12), the greater the risk — which may suggest a time-dependent or dose-dependent relationship
Looking at absolute numbers
However, it's worth looking at the absolute figures as well.
In the 18–64 age group:
- Dementia was diagnosed in 1.9% of those taking gabapentin
- vs. 0.9% of those not taking gabapentin
That's a relative increase, but we're still talking about a few people per hundred over 10 years.
Very important: correlation ≠ causation
This was an observational study. That means a statistical association was demonstrated, but it was not proven that gabapentin causes dementia.
It remains unknown whether the effect was due to:
- The medication itself
- Chronic pain
- Other diseases
- Other medications
- Lifestyle factors
What about "heavy metals"?
In the study published in *Regional Anesthesia & Pain Medicine*, heavy metal content in the medication was not analyzed. There is no evidence confirming that alleged "toxic metals" are the cause of increased risk. This is most likely a media overinterpretation.
What this means for patients
- Do not stop the medication on your own
- Do not panic
- If you use gabapentin long-term, it's worth discussing the benefit-risk balance with your doctor
- Pay attention to symptoms such as:
- Memory deterioration
- Difficulty concentrating
- Disorientation
- Noticeable slowing of thought
Abrupt discontinuation can cause worsening pain, sleep disturbances, or withdrawal symptoms.
What else is worth remembering
Chronic pain itself:
- Worsens concentration
- Increases the risk of depression
- Affects cognitive function
- Disrupts sleep
Sometimes effective pain treatment can actually improve cognitive function.
Summary
This is an important study that shows a possible association between long-term gabapentin use and the risk of cognitive impairment.
However, it is not proof of causation, and it does not mean that every patient taking the medication will develop dementia.
- Not every person taking gabapentin is at risk for cognitive impairment
- Not every long-term therapy is harmful
- Calm, awareness, and good communication with your doctor are a far better strategy than fear triggered by an internet headline
References:
References:
https://pubmed.ncbi.nlm.nih.gov/40639955/
Natalia — since 2014 I've been living with trigeminal nerve pain. I write in plain language, based on reliable sources and personal experience. Read my story →
Frequently Asked Questions
What is the difference between neuralgia and neuropathy?
In simple terms: neuralgia primarily involves paroxysmal pain along a nerve, usually without loss of sensation. Neuropathy involves nerve damage that more often causes constant pain along with numbness and sensory loss.
Do regular painkillers help with neuropathic pain?
Usually not. Neuropathic pain responds poorly to paracetamol or anti-inflammatory drugs. Instead, medications that act on nerves are used, such as anticonvulsants like carbamazepine.
What is the difference between gabapentin and pregabalin?
Both are anticonvulsant medications used for neuropathic pain. They differ in absorption and dosing characteristics. The choice and dosage should be determined by a physician.
Does alpha-lipoic acid (ALA) help with neuropathy?
Some people use ALA as a supportive supplement, but evidence is limited and comes mainly from studies on diabetic neuropathy. It is considered a supplement, not a proven therapy. Always consult your doctor.
Which doctor should I see for facial pain?
First, see a neurologist. If surgery is being considered, a neurosurgeon. If a dental cause is suspected, it is also worth ruling it out with a dentist.
Related Articles
Neuropathic Pain After Dental Procedures — A Serious and Underrecognized Complication
Trigeminal neuralgia and chronic neuropathic pain following dental procedures are serious and often underestimated complications encountered in dental prac…
Opioids for Neuropathic Pain — When Standard Treatment Is Not Enough
Neuropathic pain, including trigeminal neuralgia, is among the most distressing and difficult-to-treat types of pain.
Chronic Neuropathic Pain — Types, Mechanisms, and Treatment
Cause: damage to or disease of the nervous system (peripheral or central).
Track your attacks, triggers, and medications — and show your doctor a clear picture of your condition.