Chronic lower back pain doesn’t just limit mobility, it can take over daily life. For millions of older adults, persistent pain leads to reliance on prescription medication just to get through the day. But recent research suggests that some of the most commonly prescribed drugs for this condition may quietly increase the risk of a devastating outcome: dementia.
A growing body of evidence shows that gabapentinoids, including gabapentin and pregabalin, may not be as benign as once believed. These drugs, often seen as safer alternatives to opioids, now appear linked to long-term cognitive decline, especially in seniors. As the use of gabapentinoids has skyrocketed in recent years, so too has concern about their impact on brain health.
New studies, highlighted by international researchers and echoed by American medical experts, urge caution. They challenge patients and doctors to weigh short-term pain relief against the potential for memory loss, confusion, and other signs of neurodegenerative disease. If you’re treating chronic back pain or caring for someone who is, these findings matter more than ever.
A Closer Look at the Research
In a long-term Taiwanese study published in Frontiers in Aging Neuroscience, researchers followed over 2,000 adults aged 60 and older who were being treated for chronic lower back pain. The study tracked patients for up to 10 years and examined their use of several pain-relieving drugs, including:
- Gabapentinoids (gabapentin and pregabalin)
- Tricyclic antidepressants
- SSRIs (selective serotonin reuptake inhibitors)
- Opioids
Among all the medications analyzed, gabapentinoids showed the strongest association with dementia. Patients using these drugs over a long period were significantly more likely to be diagnosed with the condition. Although tricyclic antidepressants also appeared to raise risk slightly, SSRIs and opioids showed no strong link to cognitive decline.
Even after accounting for age, medical history, and other risk factors, the data remained consistent. The connection between gabapentinoids and memory loss couldn’t be ignored.
What Makes Gabapentinoids Risky?
Gabapentinoids are designed to calm overactive nerve signals by blocking calcium channels in the brain and spinal cord. This process helps reduce nerve-related pain, which is common in conditions like sciatica and diabetic neuropathy. Doctors also prescribe these drugs for anxiety, insomnia, and migraines.
However, that same calming effect can dull mental function. Older adults who take gabapentin or pregabalin often report confusion, fatigue, and memory lapses. These aren’t just minor side effects, they can build up over time and possibly lead to neurodegenerative disease, such as dementia.
A key concern is that these symptoms often fly under the radar. Many patients, and even their doctors, may chalk up forgetfulness or brain fog to natural aging. But this study suggests gabapentinoids may be part of the problem, not just an innocent bystander.
Expert Warnings From the U.S.
While the Taiwanese study is significant, U.S. health experts are sounding the alarm as well. According to a report by Fox News, Dr. Marc Siegel, a clinical professor at NYU Langone, emphasized that gabapentin is “not harmless,” especially in the elderly. He warned that cognitive changes can creep in quietly and become more severe with prolonged use.
Research shows that gabapentinoid prescriptions have soared in recent years, particularly as doctors seek alternatives to addictive opioids. However, without long-term safety data for seniors, many now urge a reevaluation of their widespread use.
Why Seniors Face the Greatest Risk
Older adults are already more vulnerable to dementia, with natural aging processes putting them at increased risk of cognitive impairment. Add in a drug that affects the central nervous system, and the danger multiplies.
Globally, over 55 million people live with dementia, and the number is rising. A modest increase in risk from gabapentinoids could impact millions. When you factor in how often these drugs are prescribed, sometimes without much scrutiny, the threat becomes even more urgent.
The very reason gabapentinoids gained popularity was their non-opioid status. But as evidence mounts, it’s clear they’re not risk-free, especially for those already at risk of mental decline.
Safer Alternatives for Managing Chronic Pain
Fortunately, you don’t have to rely solely on medication to manage chronic lower back pain. Many doctors now recommend starting with non-pharmacological treatments, particularly for seniors.
Here are safer, research-supported alternatives:
- Physical therapy improves posture and reduces strain
- Cognitive behavioral therapy (CBT) changes pain perception patterns
- Mindfulness, breathing, and meditation lower stress and improve pain tolerance
- Massage, acupuncture, and stretching relieve muscle tension
- Heat and cold therapy provide targeted relief
While these methods may not work overnight, they build resilience and reduce dependence on potentially risky drugs. Often, a combination of treatments yields the best results, with fewer side effects and no threat of cognitive deterioration leading to dementia.
What Patients and Caregivers Should Do Now
If you’re currently taking gabapentin or pregabalin, don’t panic, but don’t ignore the risks either. You should never stop medication without consulting a doctor. Instead, schedule a conversation about your treatment plan and explore options to reduce or replace long-term use.
For caregivers, stay alert to signs of memory loss, confusion, or changes in behavior. These could indicate drug-related cognitive issues. Advocate for your loved one by bringing up concerns with their doctor and asking about alternatives.
Doctors, in turn, should monitor patients closely, especially when prescribing gabapentinoids to older adults. Low doses, limited duration, and regular cognitive checks are essential.
Rethinking Pain and Brain Health
Chronic back pain can feel relentless. It interferes with sleep, mobility, and mental well-being. But treatment should never come at the cost of brain health.
The link between gabapentinoids and dementia is too strong to ignore. Although these medications can help in the short term, their long-term use may silently damage the brain, particularly in older adults.
Patients and healthcare providers must now strike a better balance. Pain relief matters, but so does protecting memory, independence, and quality of life. With greater awareness and smarter choices, we can manage pain without sacrificing the mind.
Read More: 10+ Side Effects of The Controversial Medication, Gabapentin