A major new study has raised concerns about gabapentin — a medication taken by millions of Americans for chronic back pain and other nerve-related issues. Researchers from Case Western Reserve University analyzed medical records from more than 26,000 adults and found that long-term use of gabapentin was associated with significantly higher rates of dementia and mild cognitive impairment (MCI). Adults who received six or more prescriptions were 29% more likely to develop dementia within a decade, and 85% more likely to develop MCI.

What surprised researchers most was how sharply the risks increased among younger adults. Patients ages 35 to 49 who used gabapentin had more than double the risk of developing dementia and more than triple the risk of MCI. Those between 50 and 64 saw similarly elevated risks, while only individuals aged 18 to 34 appeared unaffected. The study also showed a dose-related pattern: the more prescriptions a patient had, the higher the cognitive risk.

Published in Regional Anesthesia & Pain Medicine, the research did not prove that gabapentin causes dementia, but the association was strong even after adjusting for other health factors. Gabapentin, originally approved for epilepsy, has seen skyrocketing use in recent decades as a perceived safer alternative to opioids. Today, it is widely prescribed for chronic back pain, nerve pain, and restless legs syndrome — often for long periods.

Experts say patients shouldn’t panic, but they should stay informed. Doctors recommend regular cognitive monitoring for anyone taking gabapentin long-term, especially middle-aged and older adults. Discussing dosage, alternatives, and duration of treatment with a healthcare provider is key. As researchers noted, the potential link between gabapentin and cognitive decline “should not be ignored,” particularly given how commonly the drug is used.