A commonly prescribed medication used for nerve pain and chronic back pain has attracted attention after a large study found an association between repeated gabapentin prescriptions and a higher incidence of dementia and mild cognitive impairment.
The finding does not mean that gabapentin causes dementia. The research was observational, meaning researchers examined existing medical records rather than randomly assigning people to take the medication. Other differences between people who use gabapentin and those who do not may partly explain the results.
Still, the findings raise an important question about long-term medication use and cognitive health, particularly in people who take gabapentin repeatedly for chronic pain.
What Is Gabapentin?
Gabapentin is a prescription medication originally developed for the treatment of certain seizures. It is also widely used to manage nerve-related pain, including pain that may occur alongside chronic back problems.
Unlike ordinary pain relievers such as ibuprofen or acetaminophen, gabapentin works primarily by affecting signaling within the nervous system.
Doctors may prescribe it when pain has a neuropathic component, such as burning, shooting, tingling, or electric-like sensations.
Because chronic pain itself can significantly affect sleep, concentration, mood, mobility, and quality of life, determining the right treatment often requires balancing potential benefits and risks.
What Did the Study Find?
The study, published in Regional Anesthesia & Pain Medicine in 2025, examined electronic health records from the TriNetX research network.
Researchers identified adults with chronic low back pain and compared patients who received gabapentin with similar patients who did not receive the medication. After propensity-score matching, the analysis included 26,416 adults.
Among patients who received six or more gabapentin prescriptions, researchers observed:
- A 29% higher relative risk of dementia
- An 85% higher relative risk of mild cognitive impairment (MCI)
- Higher observed risks with more frequent prescriptions
Patients who had received 12 or more prescriptions also had higher observed rates of dementia and MCI than people who had received three to 11 prescriptions.
These numbers describe relative risk, not a 29% or 85% absolute chance of developing dementia.
That distinction is important. A relative increase does not mean that everyone taking gabapentin will develop dementia.
The Findings in Younger Adults Were Unexpected
Dementia is generally associated with advancing age, which made some of the study’s age-specific findings particularly notable.
Researchers reported that adults ages 18–64 who had been prescribed gabapentin had higher observed risks of dementia and MCI than comparable adults who had not received the medication.
The association was especially pronounced in the study’s 35–49 and 50–64 age groups. However, these subgroup findings should also be interpreted cautiously because observational subgroup analyses can be affected by differences between patient populations.
The researchers did not establish that gabapentin itself caused cognitive decline.
Does Gabapentin Cause Dementia?
The study cannot answer that question.
This is perhaps the most important point to understand when reading headlines about the research.
The study was retrospective and observational. Researchers looked at medical records and identified an association between gabapentin prescriptions and later diagnoses of dementia or MCI.
Even though the researchers adjusted for several patient characteristics and medications, there can still be confounding—other factors associated with both chronic pain and cognitive health that were not completely captured in the database.
For example, chronic pain can affect physical activity, sleep, mood, social functioning, and overall health. These factors may themselves be associated with cognitive outcomes.
The researchers also noted limitations involving the inability to fully account for factors such as the precise dose and duration of gabapentin treatment.
Other Research Has Produced Mixed Results
The 2025 study is not the only research examining gabapentin and dementia.
A 2024 Taiwanese nested case-control study involving more than 200,000 adults with chronic pain found no significant difference in dementia risk according to cumulative gabapentin dose. Its adjusted analysis did not show a substantial increase in dementia risk with higher cumulative exposure.
More recently, a 2026 systematic review and meta-analysis of five observational studies involving more than 325,000 participants reported a modest association between gabapentinoid use and Alzheimer’s disease-related dementia. However, the researchers described the overall certainty of evidence as low, with substantial variation between studies and important concerns about residual confounding and confounding by indication.
In other words, the research is worth watching, but it has not established a simple cause-and-effect relationship.
What About Brain Fog and Drowsiness?
Even without assuming that gabapentin causes dementia, the medication can affect the nervous system.
Some people taking gabapentin may experience symptoms such as:
- Drowsiness
- Dizziness
- Fatigue
- Difficulty concentrating
- Feeling mentally slowed or “foggy”
- Problems with coordination
These effects are different from dementia.
A person experiencing temporary sleepiness or cognitive slowing while taking a medication should not automatically assume they are developing a neurodegenerative disease.
However, new or worsening confusion, memory problems, unusual behavior, or difficulty functioning should be discussed with a healthcare professional.
Should You Stop Taking Gabapentin?
Do not stop gabapentin suddenly without medical advice.
Gabapentin is a prescription medication, and abruptly changing or stopping it can cause problems, particularly in people taking it regularly or for seizure control.
If you have been taking gabapentin for chronic back or nerve pain for a long time, talk with your doctor or pharmacist about:
- Why you are taking it
- Whether it is still helping your symptoms
- Your current dose
- How long you have been taking it
- Other medications you take
- Any new memory or concentration problems
- Whether your treatment should be continued, adjusted, or gradually reduced
The decision should be based on your individual circumstances rather than a headline about a single observational study.
Why Medication Reviews Matter
Long-term medication use is worth reviewing periodically, particularly when several medicines are involved.
A medication review can help determine whether each medicine is still necessary and whether there are interactions or side effects that should be addressed.
This is especially relevant for older adults, people taking multiple medications, and people who have developed new symptoms after starting or increasing a medicine.
Don’t Forget the Role of Chronic Pain
It is also important not to view the relationship between pain medication and dementia in isolation.
Chronic pain can interfere with sleep and daily activity. It may make exercise more difficult and can affect a person’s ability to participate in normal social and physical activities.
Those factors can complicate observational research because people who require long-term pain treatment may differ from people who do not need it in many ways.
This is one reason why researchers cannot simply conclude that a medication is responsible for every difference observed between medication users and non-users.
When to Talk to Your Doctor
If you take gabapentin and notice persistent or worsening cognitive changes, speak with your healthcare professional.
Particularly important symptoms include:
- New or worsening confusion
- Significant memory changes
- Difficulty performing familiar daily tasks
- Severe or persistent dizziness
- Excessive sleepiness
- Problems with coordination or walking
- Major changes occurring soon after a dose increase
These symptoms can have many possible causes, including medications, sleep problems, infections, metabolic problems, neurological conditions, or other health issues.
The Bottom Line
A large 2025 medical-record study found that adults with chronic low back pain who received repeated gabapentin prescriptions had higher observed rates of dementia and mild cognitive impairment than similar patients who did not receive the medication.
However, the study does not prove that gabapentin causes dementia. Other research has produced different findings, and a 2026 systematic review concluded that the overall evidence remains limited and affected by substantial uncertainty.
For people taking gabapentin, the sensible response is not panic or suddenly stopping treatment. Instead, discuss long-term use, benefits, side effects, and any cognitive symptoms with a qualified healthcare professional.
The research is an important reason for continued investigation—but it is not evidence that everyone taking gabapentin will develop dementia.