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Medical News Today
4 days ago
- Health
- Medical News Today
Gabapentin users may face 85% higher cognitive impairment risk
Gabapentin is a medication that, in the United States, is approved to treat seizures and shingles-related neuralgia. It is also used off-label to treat other health issues, including low back pain. Past studies have also found that using gabapentin may increase a person's risk of developing cognitive impairment and dementia. A new study reports that people who receive six or more prescriptions of gabapentin for lower back pain are at a higher risk of developing dementia and mild cognitive found these risks were more than doubled in adults between the ages of 35 to 49 is a medication that is approved by the Food and Drug Administration (FDA) for the treatment of some epileptic seizures, moderate-to-severe restless legs syndrome, and postherpetic neuralgia, which is a nerve pain associated with shingles. Additionally, gabapentin is sometimes prescribed off-label for anxiety disorders, insomnia, hot flashes, alcohol use disorder, akathisia, diabetic peripheral neuropathy, and lower back pain. Like all medications, gabapentin has some potential side effects, including dizziness, tiredness, water retention, and dry mouth. Past studies have also found that using gabapentin may cause breathing difficulties, and may increase a person's risk of developing cognitive impairment and dementia. Now, a new study published in the journal Regional Anesthesia & Pain Medicine reports that people who receive six or more prescriptions of gabapentin for lower back pain are at a higher risk of developing dementia and mild cognitive impairment (MCI). Scientists also discovered these risks were more than doubled in adults between the ages of 35 to 49 How does it affect dementia, MCI risk?For this study, researchers analyzed data from more than 26,000 adults through the federated health research network selected participants who had a diagnosis of chronic pain, chronic pain syndrome, lumbar radiculopathy, and chronic low back pain. They also categorized study participants into different age groups: 18–64, 18–34, 35–49, 50–64, and 65 or older. Researchers assess 10-year outcomes on study participants to see what percentage developed dementia, generally, or specifically Alzheimer's disease, vascular dementia, or MCI. 'Currently, there is a discrepancy on whether taking gabapentin increases a patient's risk for developing dementia,' Nafis B. Eghrari, a 4th-year medical student at Case Western Reserve University School of Medicine in Cleveland, OH, and first author of this study, told Medical News Today.'Moreover, there lacks a strong understanding of how gabapentin impacts cognitive function and whether it contributes to neurodegenerative processes. Previous studies have shown mixed findings on this topic. Thus, we decided to explore this gap in the field,' explained Eghrari.6 or more gabapentin prescriptions linked to 85% higher MCI riskUpon analysis, researchers found that study participants who received six or more gabapentin prescriptions had a 29% higher risk of developing dementia, and an 85% greater chance of being diagnosed with MCI.'The significance of this finding is an association between gabapentin prescription and dementia on a nationwide level,' Eghrari explained. 'Though this does not imply causation, this warrants further investigation on the drug's long-term effects.''In terms of clinical significance, I recommend that physicians prescribing gabapentin for chronic pain perform cognitive exams on a regular basis when seeing patients,' he continued.'I'd also advise patients who are taking this drug to alert their physician if they notice any cognitive deficits, including confusion, poor memory, or slowed thinking,' said the doubled in 35–49-year-oldsEghrari and his team also discovered that when looking at participants by age groups, the risks for dementia more than doubled and more than tripled for MCI in people who were 35 to 49 years old. 'We were surprised to find this relatively higher risk in the non-elderly population,' Eghrari said.'These results indicate that gabapentin may have a greater cognitive impact on non-elderly individuals, as elderly individuals are already at risk for neurodegeneration due to their older age. This finding warrants further investigation into the underlying mechanism of how gabapentin may impact cognition.' – Nafis B. Eghrari'The key takeaway of this study is that patients prescribed gabapentin for chronic back pain should be closely monitored by their physician for cognitive decline,' he continued. 'Moreover, gabapentin should be prescribed with caution due to the associated risk of dementia/cognitive impairment.''We hope to carry this research forward and explore whether there is a true causative relationship between gabapentin and cognitive impairment,' Eghrari added. 'We also plan to investigate the underlying mechanisms of how the drug may impact cognition.'What are the drawbacks of large dataset studies?MNT had the opportunity to speak with Neel Anand, MD, MCh Orth, a board-certified orthopedic spine surgeon and director of the Cedars-Sinai Spine Center in Los Angeles, about this study. Anand, who was not involved in the research, commented that there are pros and cons to studies with big data sets as there are many variables and it is hard to determine the true causative little or no information was provided on any other illnesses participants may have had or other medications they were taking.'The best thing I would take from the study is […] [that] there's not a single drug without a side effect — they all have some issues,' Anand pointed out. 'So the answer is, if you're chronically going to take something, you better watch out — something's [potentially] going to go wrong somewhere.'Anand said the best way to prove anything is to take a cohort of study participants who take a specific medication and nothing else, and compare them to another cohort who does not take the medication. And researchers need to ensure that participants take the medication if it is prescribed to noted that, in some cases, patients do not follow the doctor's indications regarding prescription medication. 'Sometimes they do more, sometimes they'll take less,' Anand said. 'The only way to actually study [the real-life effects of long-term drug use] would be to literally take a thousand people and give them gabapentin and nothing else, and a thousand you don't, and then follow them over 5 years or more,' he he admitted that 'at least we can be cognizant' that there may be a heightened risk of dementia with prolonged gabapentin is 'a possibility that [doctors] needs to be aware [of] or at least counsel our patients [on] — that's fair,' Anand added.
Gizmodo
5 days ago
- Health
- Gizmodo
This Common Pain Med Could Be Raising Dementia Risk
Chronic pain can be a debilitating experience. A common medication used to manage the condition may come with its own serious dangers, however. Recent research finds an upsetting link between the drug gabapentin and a higher risk of dementia. Scientists at Case Western Reserve University led the study, which examined the medical records of people with chronic low back pain. People taking gabapentin for their back were significantly more likely to develop dementia over time compared to non-users, they found. The results suggest that doctors ought to be more aware of this potential complication, the researchers say. 'Our findings indicate an association between gabapentin prescription and dementia or cognitive impairment within 10 years,' they wrote in their paper, published last week in the journal Regional Anesthesia & Pain Medicine. Ozempic Might Be a Dementia Buster, Too Gabapentin is an anti-seizure drug that's also regularly used to manage nerve pain and restless leg syndrome. And it's sometimes used to treat chronic low back pain, especially if the nerves are thought to be involved. The drug primarily works by reducing the abnormal electric activity of the brain's neurons. As useful as gabapentin can be, some—if not all—research has suggested a possible link to dementia and cognitive impairment. To better understand this potential risk, the study researchers examined its use among chronic low back pain patients. They analyzed the medical records of over 26,000 patients diagnosed with back pain between 2004 and 2024, comparing similar groups of patients who either were or weren't prescribed gabapentin. People who were prescribed gabapentin six or more times were significantly more likely to be diagnosed with dementia (roughly 30% more likely) and mild cognitive impairment (85% more) than those who weren't, the researchers found. This increase in relative risk was higher in people under the age of 65 as well as in those taking 12 or more prescriptions of gabapentin (compared to people receiving fewer prescriptions). These U.S. States Have the Highest Rates of Dementia These sorts of retrospective studies can only demonstrate a correlation between two things, not prove a clear cause-and-effect relationship. But the findings should motivate further research, both to confirm whether this link is genuine and to figure out the exact mechanisms behind it, the researchers argue. And for now, doctors should at least be more careful in how they prescribe gabapentin, including being more proactive in tracking the cognitive health of their patients taking it. 'Our results support the need for close monitoring in adult patients prescribed gabapentin to assess for potential cognitive decline,' the study researchers wrote.
