A Common Drug Prescribed For Chronic Back Pain May Lead To Higher Risk Of Dementia

Back pain can really interfere with your quality of life, and it's one of the most common reasons people miss work. If you've never had back pain before, just wait. About one in four people in the U.S. are currently dealing with lower back pain, and around 80% will experience it at some point in their lives, according to the National Institutes of Health.

For some people, chronic back pain is so severe that they may need to take a prescription drug. Gabapentin is an anticonvulsant typically used to control seizures or treat nerve pain from shingles, but it is sometimes prescribed off-label for lower back pain. A 2025 study in Regional Anesthesia and Pain Medicine found that people who took gabapentin for back pain had a 29% higher risk of developing dementia. Compared to people who didn't take gabapentin, those who did were 85% more likely to develop mild cognitive impairment.

The risk was especially high for people under 65 taking gabapentin. Adults between 18 and 65 who took gabapentin had double the risk of developing dementia compared to those who never used it. People with more than 12 prescriptions of gabapentin also had an increased risk of dementia compared to people who didn't take it as long. Although this study couldn't determine that gabapentin causes dementia, it may be useful to understand how gabapentin works in the brain.

The "GABA" in gabapentin stands for gamma-aminobutyric acid, because gabapentin works similarly to the GABA neurotransmitter in your brain that helps calm your nervous system. That's why gabapentin is often used for nervous system conditions like seizures, restless legs syndrome, and nerve pain. It enters the brain and quiets overactive nerves, but researchers believe it may also interfere with the brain's ability to form new connections, especially in areas important for memory.

A 2023 study in Frontiers in Pharmacology also found a link between gabapentin and cognitive decline. The study didn't specifically focus on people taking gabapentin for back pain, and it also looked at pregabalin, a similar drug used to treat nerve pain from fibromyalgia and diabetes. Taking gabapentin or pregabalin was associated with a 45% higher risk of dementia, and the risk increased the longer people stayed on the drug. Adults under 50 who took either medication had three times the risk of dementia compared to older adults.

However, gabapentin may help manage agitation and aggression symptoms in people with dementia. A 2018 review in the British Journal of Clinical Pharmacology found that patients with dementia who were prescribed either gabapentin or pregabalin showed reduced agitation and aggression. One man with Alzheimer's and vascular dementia not only became less aggressive after starting gabapentin, but he also slept better and became more communicative.

Although gabapentin is approved to treat seizures and other nerve-related issues, it's also been used for conditions like depression, anxiety, headaches, and back pain. With that said, gabapentin isn't ideal for all types of back pain. Because sciatica involves the sciatic nerve, gabapentin may help relieve that kind of pain. However, muscle-related back pain is usually better treated with physical therapy and nonsteroidal anti-inflammatory drugs (NSAIDs).

Like any drug, gabapentin can cause side effects. Common side effects of gabapentin include dizziness, drowsiness, headache, and nausea. Some people may experience more serious side effects, such as trouble speaking, weight gain, or memory loss. If you're also taking antidepressants, antihistamines, or opioids, gabapentin could increase your risk of breathing problems. Men may also experience erectile dysfunction while on gabapentin. Talk to your doctor if you have bothersome side effects. And don't stop taking gabapentin suddenly because it can cause withdrawal symptoms like anxiety or agitation.