Six or more prescriptions of anti-epileptic drug, gabapentin, for low back pain are linked to a significantly higher risk of developing dementia and mild cognitive impairment. The corresponding study was published in Regional Anesthesia & Pain Medicine.
Gabapentin was approved in 1993 by the FDA to treat partial seizures. It has also been used to treat chronic pain for more than 20 years. While some research suggests that the drug may be linked to an increased risk of dementia, other research suggests the opposite. In the current study, researchers investigated the risk of dementia following gabapentin prescription in patients with chronic pain.
To do so, they conducted a retrospective cohort study including 26, 416 adults across the US who had been diagnosed with chronic low back pain. Primary outcomes were dementia and mild cognitive impairment.
Those who had received six or more prescriptions for gabapentin were 29% more likely to receive a dementia diagnosis and 85% more likely to be diagnosed with mild cognitive impairment within 10 years of their initial pain diagnosis.
When stratified by age, the researchers found that patients aged 18-64 years old who had been prescribed the drug were more than twice as likely to develop either condition compared to those without a prescription.
While risk did not increase among 18-34-year-olds prescribed the drug, they found that dementia risk more than doubled among 35- 49-year-olds, while risk of mild cognitive impairment more than tripled. Similar patterns were observed among 50- 64-year-olds.
The researchers further found that risk of the conditions rose with prescription frequency. Patients with 12 or more prescriptions were 40% more likely to develop dementia and 65% more likely to develop mild cognitive impairment than those prescribed gabapentin between 3 and 11 times.
“Our results support the need for close monitoring in adult patients prescribed gabapentin to assess for potential cognitive decline. We hope the current study promotes further research to delineate whether gabapentin plays a causal role in the development of dementia and the underlying mechanisms of this relationship,” wrote the researchers in their study.
