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Receiving six or more prescriptions of the drug gabapentin for low back pain is associated with significantly increased risks of developing dementia and mild cognitive impairment (MCI)—29% and 85%, respectively—finds a large medical records study published online in the journal Regional Anesthesia & Pain Medicine.
What's more, these risks were more than twice as high in those normally considered too young to develop either condition—18–64-year-olds—the findings indicate.
Unlike opioids, gabapentin has relatively low addictive potential, and it has become increasingly popular for the treatment of chronic pain, especially neuropathic pain, as it offers potentially neuroprotective benefits, point out the researchers.
But concerns are beginning to emerge about its side effects, including a possible association with neurodegeneration, although the findings to date have been mixed, including whether particular age groups might be more vulnerable, they add.
In a bid to shed more light on these issues, the researchers drew on real-time data from TriNetX, a federated health research network, which contains electronic health records from 68 health care organizations across the U.S.
They scrutinized the anonymized records of adult patients who had and hadn't been prescribed gabapentin (26,414 in each group) for chronic low pain between 2004 and 2024, taking account of demographics, co-existing conditions, and the use of other analgesic drugs.
Those who had received six or more gabapentin prescriptions were 29% more likely to be diagnosed with dementia and 85% more likely to be diagnosed with MCI within 10 years of their initial pain diagnosis.
And when the records were stratified by age, 18–64-year-olds prescribed the drug were more than twice as likely to develop either condition than those who hadn't been prescribed gabapentin.
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