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Gabapentin has been increasingly prescribed to older adults for off-label indications, and accumulating evidence suggests potential for gabapentin misuse and related adverse events. However, the relation between gabapentin initiation and longer-term neurocognitive changes is not well understood. Moreover, dementia risk increased along with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less. The University of Washington study is the first to include nonprescription drugs. Several studies suggest that using gabapentin and pregabalin for epilepsy control is associated with an increased risk of dementia, and the effect appears to be lifelong (Knight et al., 2021). However, these studies specifically involved patients with epilepsy or medically ill patients. The high death toll of people with dementia in such facilities during the COVID-19 pandemic may increase that motivation, he notes. And the lack of information for clinicians on the use of these drugs in dementia makes every prescription a judgment call. The evidence of gabapentin and dementia is mixed, with two studies looking at hundreds of thousands of people and coming to completely different conclusions. We estimated the yearly prevalence of gabapentin use, both overall and within subgroups defined by cognitive status [normal, mild cognitive impairment, and dementia] and demographics [age and sex] for participants aged 65+. The multivariate-adjusted hazard ratio of risk of dementia for gabapentin or pregabalin exposure versus the matched non-exposed group was 1.45 (95% confidence interval [CI], 1.36–1.55). The risk of dementia increased with higher cumulative defined daily doses during the follow-up period. Cognitive decline was defined as any increase in the Clinical Dementia Rating global score (CDRGLOB) and as a 1-point increase in CDR sum of boxes (CDR-SB). Functional status decline was defined as a 3-point increase in the sum of the Functional Activities Questionnaire (FAQ) and as 0.3-point increase in mean FAQ. The short answer is: yes, emerging evidence suggests that gabapentin, and its close relative pregabalin, may indeed increase the risk of developing dementia, particularly with long-term use and higher cumulative doses. While it’s not a definitive “cause,” studies are highlighting a concerning correlation that warrants further Gabapentin use was significantly associated with decline in cognitive and functional status among older adults with initially normal cognition. Further studies are needed to examine the association. In a recent population-based cohort study, Huang et al. identified a notable association between cumulative use of gabapentin and pregabalin and an increased risk of dementia, notably in younger demographics and those on higher dosages (Huang et al., 2023). This contrasts with our findings, which did not demonstrate significant differences in And since treatment options for dementia are limited, prevention is key. Dementia risk is tied to common things like diabetes, high blood pressure, and physical inactivity. But some common medications are associated with dementia risk, too. Here are four common drug classes linked to dementia, and what the research says about your risk. 1. AEDs in the study included levetiracetam, valproate, clonazepam, topiramate, carbamazepine, lamotrigine, gabapentin, pregabalin, primidone, and others. There was no significant association between any use of AEDs and dementia risk (OR = .99). The duration of AED therapy was also not associated with a risk of dementia (OR = 1.00 per therapy year). Recent studies have begun to paint a clearer picture regarding the relationship between Gabapentin and Alzheimer’s disease. 1. Cognitive Function and Memory Impairment. Some research indicates that Gabapentin may have an impact on cognitive function, particularly in older adults. Here are some key findings: Long-term Gabapentin therapy for chronic pain is not associated with a differential risk of dementia across dosage levels, irrespective of age or gender. Further study into its potential cognitive impacts is essential. The multivariate-adjusted hazard ratio of risk of dementia for gabapentin or pregabalin exposure versus the matched non-exposed group was 1.45 (95% confidence interval [CI], 1.36-1.55). The risk of dementia increased with higher cumulative defined daily doses during the follow-up period. Given the known increased risk of dementia with certain medications, we try to get patients off of these medications, if possible. We have seen patients’ cognition improve as a result. Q. Our results provide evidence that gabapentin was associated with increased odds of global cognitive decline, functional status decline, and motor function change (e.g., falls and slowness) in the 2 years following gabapentin initiation. Gabapentin use has been associated with memory loss and cognitive decline. Studies suggest that the risk of dementia may be higher in patients treated with gabapentin. It is important for patients and healthcare providers to be aware of the potential cognitive side effects of gabapentin. Most of the data to guide gabapentin use and dosing in older adults is from pharmacokinetic studies or case reports[1,2] While gabapentin is approved to prevent seizures, most patients take gabapentin for reasons of neuropathic pain (71%) or psychiatric disorders, with bipolar being most common (15%), with an average dose of 975 mg per day
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