A recent study has raised concerns about gabapentin (Neurontin) and its potential link to cognitive impairment, particularly in older adults or those taking higher doses. Here’s what you should know:

Key Findings:

• 85% Higher Risk: Research suggests gabapentin users may have an 85% increased risk of developing cognitive impairment (e.g., memory loss, confusion, difficulty concentrating) compared to non-users.
• Stronger in Older Adults: The risk appears more pronounced in older patients (65+), especially those with pre-existing conditions like dementia or kidney dysfunction.
• Dose-Dependent Effect: Higher doses (e.g., >1,200 mg/day) and long-term use may further elevate risks.

Why Might Gabapentin Affect Cognition?

• GABA Activity: Gabapentin modulates GABA (a calming neurotransmitter), which may contribute to brain fog or slowed thinking.
• Sedation & Confusion: Like other CNS depressants, it can cause drowsiness, dizziness, and mental clouding.
• Kidney Function Impact: Poor kidney clearance (common in aging) can lead to drug accumulation, worsening side effects.

Who Should Be Cautious?

• Older adults (especially those with dementia or mild cognitive impairment).
• Patients on multiple CNS-acting drugs (e.g., opioids, benzodiazepines, antidepressants).
• Those with kidney disease (requires dose adjustments).

What Can Patients Do?

Discuss Alternatives – For nerve pain or seizures, ask about safer options (e.g., pregabalin may have a different risk profile).
Monitor Symptoms – Report memory lapses, confusion, or attention issues to a doctor.
Avoid High Doses – Use the lowest effective dose for the shortest duration.
Check Kidney Function – Ensures proper dosing if kidneys aren’t filtering well.

While gabapentin is effective for nerve pain, epilepsy, and other conditions, this study highlights a potential cognitive risk—especially in vulnerable groups. If you or a loved one is on gabapentin, consult a doctor before making changes, but consider discussing risk vs. benefit if cognitive concerns arise.

Reference:

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/explained-gabapentin-dementia-risk-gabapentins-hidden-side-effectsfrom-pain-relief-to-brain-fog/articleshow/122578137.cms

https://pubmed.ncbi.nlm.nih.gov/40639955

https://www.medicalnewstoday.com/articles/gabapentin-users-may-face-85-higher-risk-of-cognitive-impairment

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