A recent study has sparked concern in the medical community, pointing to a surprising possible connection between a widely used pain and seizure medication and long-term cognitive decline. Millions of people around the world take this drug every year, trusting in its reputation as a safer alternative to opioids and a reliable treatment for chronic pain. But researchers now warn that long-term use might come with a hidden cost.
The medication has been prescribed for a range of issues—nerve pain, anxiety, sleep problems, and even menopausal hot flashes. Its popularity stems from the fact that it’s not considered highly addictive. But just because it is seen as “safer” doesn’t mean it’s free of risks. A new large-scale analysis suggests that prolonged exposure may quietly raise the chances of developing mild cognitive impairment and even dementia.
That drug is gabapentin, an FDA-approved anticonvulsant often prescribed for epilepsy and chronic pain. The study, published in Regional Anesthesia & Pain Medicine, examined data from more than 26,000 adults diagnosed with chronic pain and compared them with a similar group who did not take the medication. Researchers followed participants across multiple age groups, analyzing outcomes over the course of a decade.
Their findings were striking: patients who had six or more prescriptions of gabapentin had a 29% increased risk of developing dementia and an 85% higher risk of mild cognitive impairment (MCI). Alarmingly, the risks were especially pronounced in adults aged 35–49—an age bracket usually considered far from dementia danger. For them, the risk doubled for dementia and tripled for MCI.
Nafis B. Eghrari, the study’s lead author and a medical student at Case Western Reserve University, emphasized that while the research shows a clear association, it does not prove causation. “There is still much we don’t know about how this drug may affect cognitive processes,” he explained. Previous research has been mixed, making this new evidence an important but incomplete piece of the puzzle.
Other experts caution against drawing hasty conclusions. Critics point out that the study did not account for variables such as physical activity levels, length of treatment, or dosage—factors that also play a role in cognitive decline. Some specialists note that patients with chronic pain might already be predisposed to reduced mobility, itself a known dementia risk.
Still, the findings highlight the importance of vigilance. Doctors prescribing gabapentin are being advised to regularly monitor patients’ cognitive health, while patients themselves should watch for symptoms such as confusion, memory lapses, or slowed thinking. Importantly, experts stress that no one should stop taking the drug without medical supervision, as sudden withdrawal can trigger serious complications, including seizures.
The research team hopes to continue exploring whether gabapentin plays a direct role in neurodegeneration or whether the correlation is driven by other factors. For now, both doctors and patients are urged to weigh the benefits of pain relief against potential long-term risks to brain health.
