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.

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 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.