01/21/2026
A medication trusted by millions for nerve pain is now raising serious questions about long-term brain health.
A large new study examining medical records from more than 26,000 patients has found a strong association between prolonged gabapentin use and increased risk of cognitive decline. Patients who received six or more prescriptions were 29% more likely to be diagnosed with dementia and 85% more likely to develop mild cognitive impairment (MCI) within ten years compared to non-users.
What’s especially concerning is who appears most vulnerable. Adults aged 35 to 49 showed an even higher relative risk, challenging the assumption that dementia-related threats are limited to older populations. Researchers are now urging clinicians to closely monitor memory, attention, and overall cognitive function in patients prescribed gabapentin for extended periods.
Gabapentin—commonly sold under brand names like Neurontin—has surged in use over the past decade, largely because it’s seen as a safer, less addictive alternative to opioids. But its very mechanism of action may also be its weakness. By suppressing communication between neurons to reduce pain, the drug may unintentionally interfere with the neural connections essential for learning, memory, and cognition.
While earlier studies produced mixed results, the size and scope of this research give new weight to mounting concerns. Importantly, scientists caution that the findings do not yet prove causation. Gabapentin may contribute directly to cognitive decline—or it may be linked indirectly through chronic pain, inflammation, or other underlying conditions. More targeted research is needed to separate cause from correlation.
For now, the message isn’t panic—but prudence. Gabapentin remains effective and appropriate for many patients, but long-term use should come with informed discussions, regular cognitive check-ins, and careful risk–benefit evaluation.
Source: Regional Anesthesia & Pain Medicine (2025)
