Explained: Gabapentin's hidden side effects—From pain relief to brain fog

Time of India

16-07-2025

Image: Getty
TL;DR
Gabapentin might raise dementia risk by ~30–40% in frequent or long-term users .
Younger users (35–64) seem especially affected
It's not proof of cause—but strong enough to rethink long-term use.
Other meds have similar risks—be informed across the board.
Lifestyle is a powerful buffer—exercise, mindful diet, social engagement, mental stimulation.
Chat with your doc, don't self-diagnose or detox alone.
You've got persistent nerve pain—maybe from shingles, back trouble, or restless legs syndrome—and your doctor prescribes gabapentin, a drug originally developed to treat seizures.
You're told it's generally safe aside from needing a bit more sleep, and sometimes feeling like your head's in a fog. But now... headlines say it might increase your risk of dementia by up to 40%.
Before you yank your prescription and panic-type in Google, let's break down what this all means.
What is Gabapentin?
Gabapentin is a medication first approved in 1993 for treating epilepsy. Soon after, its knack for reducing nerve pain—from post-shingles neuralgia to diabetic neuropathy—made it wildly popular.
It's generally considered safer and less addictive than opioids. Side effects? Sure—sleepiness, dizziness, headaches, nausea. But for many, the relief from chronic pain outweighs those little annoyances.
New study: What did researchers do and find?
A recent
study
published in Regional Anesthesia & Pain Medicine analyzed records from 68 U.S. health systems, comparing patients with chronic low back pain. The ones who'd had six or more prescriptions of gabapentin were 29% more likely to develop dementia, and 85% more likely to experience mild cognitive impairment (MCI)—all within a decade of their first pain diagnosis.
The darker stat? People with 12 or more prescriptions faced a 40% increased dementia risk and a 65% bump in MCI risk versus those with fewer prescriptions. Age mattered too. Those aged 35–64 saw more dramatic effects, with dementia risks doubling for 35–49-year-olds and MCI risk tripling.
So, should you ditch Gabapentin?
Not without chatting with your doctor. Here's the smart play:
Doctors might explore alternatives, such as topical therapies, antidepressants (off-label), or even non-drug therapies like mindfulness or physical therapy.
Lifestyle remains king: exercise, brain games, healthy diet—all proven to protect cognition .
What about other dementia-linked medications?
This isn't just about gabapentin. Other common drugs have been under the microscope:
Benzodiazepines (like Valium, Xanax) and opioids have also been linked to higher
dementia
risks
Over-the-counter meds like Benadryl (diphenhydramine) and omeprazole (for heartburn) might have their own
concerns
if used long-term
Gabapentin is unique in that it's often seen as a safer alternative—but newer evidence means we may need to rethink that assumption.
Why are these associations possible?
Several biological theories are floating around:
CNS depression: Gabapentin calms brain activity—great for hyperactive nerves. But could it also dull cognition over time? Possibly.
Chronic pain itself is linked to faster memory decline. So is pain causing dementia, or is gabapentin? Hard to say.
Lack of physical activity and social isolation often accompany chronic pain—and both are known dementia risk factors.
So it might be a combination of factors, not just the drug itself.
What should you do if you're on Gabapentin?
Here's a mini checklist to guide your next steps:
Talk to your doctor—especially if you've been prescribed gabapentin frequently or long-term.
Ask about brain monitoring: cognitive assessments every year or two could catch changes early.
Explore alternatives: viability depending on your condition—other meds or therapy.
Boost lifestyle defenses: walk, chat, do puzzles, eat well. (Yep, the brain benefits from spinach and Sudoku.)
Educate your support system: family and friends can help notice memory lapses.
Don't abruptly quit: stopping suddenly could worsen pain or trigger withdrawal—the switch should be managed.
Bottom Line
Gabapentin has been a go-to painkiller, especially as we try to avoid opioids.
New research suggests a link to dementia risks, particularly with frequent/prolonged use.
But it's not a deal-breaker—especially if you use it responsibly and under medical supervision.
Still, this is a wake-up call: time to talk to your doctor, think critically, and monitor brain health.
Gabapentin-dementia risk FAQs:
Does gabapentin really increase the risk of dementia?
Recent research suggests that long-term or frequent use of gabapentin may be associated with a higher risk of developing dementia or mild cognitive impairment. However, the study was observational, so it doesn't prove causation. It highlights the need for more research and regular cognitive monitoring in long-term users.
Who is most at risk from gabapentin-related cognitive issues?
The study found that people aged 35 to 64, especially those who had 6 or more prescriptions over time, were at higher risk. Those with 12 or more prescriptions had up to a 40% increased risk of developing dementia compared to people who used less or none.
Should I stop taking gabapentin if I'm currently using it for pain?
No—do not stop taking gabapentin suddenly, especially without consulting your doctor. If you're concerned, speak with your healthcare provider to review your dosage, explore alternatives, or discuss ways to monitor your cognitive health.
Are there safer alternatives to gabapentin for managing nerve pain?
Yes, depending on your condition. Alternatives include physical therapy, certain antidepressants, topical treatments, or other medications. Your doctor can recommend the best option based on your specific needs and health history.
How can I protect my brain health while managing chronic pain?
Besides regular medical reviews, focus on brain-friendly habits: stay physically active, eat a balanced diet, manage stress, stay socially connected, and challenge your mind with puzzles, reading, or learning. These lifestyle habits can support cognitive function even while managing long-term pain.