Is Gabapentin Linked to Dementia?

Gabapentin is an anti-seizure medication first approved by the FDA in 1993 and marketed under the brand name Neurontin.

Its approved uses include treating postherpetic neuralgia, a form of pain that can persist after shingles, and use with other medications to treat epileptic seizures involving partial onset.

Patients may hear about gabapentin when discussing shingles, nerve pain, seizures, and chronic back pain.

The drug does not treat the shingles infection itself, and its use for chronic back pain is off-label.

Doctors also prescribe gabapentin off-label for certain chronic pain conditions, anxiety, hot flashes, and other conditions.

Immediate-release gabapentin is sometimes prescribed for restless legs syndrome, although gabapentin enacarbil is the formulation specifically approved for that condition.

Gabapentin binds to alpha-2-delta subunits of voltage-gated calcium channels in the central nervous system, affecting nerve signaling.

This helps explain its use to treat seizures and neuropathic pain but does not show that it causes Alzheimer’s disease.

According to the FDA’s Neurontin prescribing information, gabapentin is cleared through the kidneys.

Patients with reduced kidney function may require lower doses because impaired clearance can increase drug exposure and adverse effects.

Observational studies have associated gabapentin exposure with higher rates of cognitive impairment, although the findings vary across patient populations and study methods.

2025 Study: Gabapentin Prescriptions and Dementia Risk

A study published in the journal Regional Anesthesia & Pain Medicine examined whether gabapentin prescriptions were associated with later cognitive diagnoses.

Researchers analyzed electronic health records from 2004 through 2024 using the TriNetX federated health research network and evaluated 26,416 propensity score-matched adults with chronic low back pain.

They compared adult patients prescribed gabapentin with similar patients who had not received it, adjusting for recorded medical and demographic differences.

The study reported significantly increased risks of dementia and mild cognitive impairment among patients with six or more prescriptions, although the observational design could not establish causation.

The principal findings were:

• Dementia: Patients with six or more gabapentin prescriptions had a 29% higher relative risk of a dementia diagnosis than matched nonusers.
• Mild cognitive impairment: The same prescription group had an 85% higher relative risk of an MCI diagnosis.
• Younger adults: Among patients ages 18 to 64 who received gabapentin, the relative risks were approximately 2.1 times higher for dementia and 2.5 times higher for MCI than among comparable nonusers.

These figures compare groups and do not mean that 29% of patients will develop dementia or that 85% will develop mild cognitive impairment.

The investigators recommended monitoring cognitive outcomes in patients prescribed gabapentin, particularly when use is repeated or prolonged.

2023 Study: Gabapentin, Pregabalin, and Dementia

A 2023 Taiwanese cohort study examined 206,802 people and reported a 45% higher adjusted hazard of dementia among patients prescribed gabapentin or pregabalin compared with matched nonusers.

Greater cumulative exposure was also associated with elevated risk.

Because the study evaluated both medications, the 45% figure is not a gabapentin-only estimate.

Other Research: Cognitive Changes and Uncertainty

A 2022 study of cognitively normal adults found that older participants who started gabapentin had worse cognitive measures at a later study visit and worse functional measures at a subsequent visit.

It did not establish that treatment caused dementia within two years.

A separate 2024 study found no statistically significant association between starting gabapentin and further cognitive decline over one or two years among older adults who already had cognitive impairment, although falls were more common.

A 2026 systematic review and meta-analysis of five observational studies involving 325,245 people found 28% higher pooled odds of Alzheimer’s disease-related dementias among gabapentinoid users.

However, the association was no longer statistically significant when the analysis was limited to studies with a low risk of bias.

The researchers rated the evidence as low certainty and could not establish cause and effect.

Repeated gabapentin prescriptions have been associated with higher dementia risk in some observational research.

In the 2025 study, patients receiving 12 or more prescriptions had a 40% higher relative risk of dementia than those receiving three to eleven prescriptions.

This is a different comparison from the 29% increase among patients receiving six or more prescriptions compared with nonusers.

Prescription frequency does not prove how many doses a person took or how long treatment continued.

The findings raise questions about whether greater cumulative exposure is associated with an increased risk of dementia, but researchers have not identified a threshold that makes gabapentin use unsafe.

Gabapentin can cause neurological side effects, including sleepiness, dizziness, and, in some clinical trials, amnesia or abnormal thinking.

These symptoms are not necessarily evidence of dementia, which involves cognitive decline severe enough to interfere with everyday activities.

Mild cognitive impairment (MCI) involves measurable changes in memory or other cognitive functions while a person remains largely independent.

Some people with MCI later develop dementia, while others remain stable or improve.

Changes that warrant medical evaluation include:

• Forgetting recent conversations, appointments, or familiar information.
• Difficulty concentrating, planning, or completing routine tasks.
• Confusion, slowed thinking, or noticeable changes in judgment.
• Increasing difficulty finding words or following conversations.

Not everyone with memory problems will develop MCI or dementia.

A person experiencing symptoms during treatment should not assume gabapentin caused a progressive neurological condition.

The major studies are observational, meaning they can identify an association but cannot conclusively determine whether gabapentin caused the diagnoses.

Chronic pain conditions may contribute to cognitive decline independently from gabapentin use through disrupted sleep, depression, reduced activity, and other health problems.

Patients also differ in age, underlying neurological health, and use of prescription medications that affect alertness or memory.

Researchers cannot always determine whether prescriptions were filled, how consistently a drug was taken, or when cognitive symptoms first appeared.

These differences may explain some of the higher risk observed among patients receiving gabapentin, even after statistical adjustment.

Patients taking gabapentin who notice persistent memory loss, confusion, or potential cognitive decline should contact their prescribing clinician.

The 2025 study’s authors advised clinicians to monitor cognitive outcomes among gabapentin recipients, particularly those with repeated prescriptions.

A medical review may consider the current dose, kidney function, other medications, and possible causes unrelated to gabapentin.

Patients can record when symptoms began, the frequency of their prescriptions, and changes noticed by family members before the appointment.

Do not stop taking gabapentin abruptly without medical guidance.

Sudden discontinuation can cause withdrawal symptoms and increase seizure risk, especially for people using gabapentin to treat epilepsy.

A clinician can determine whether medication changes or a gradual dose reduction are appropriate.

Gabapentin lawsuits allege that manufacturers, including Pfizer, failed to adequately warn patients and healthcare providers about possible cognitive risks.

The claims involve individuals who received dementia, early-onset dementia, or MCI diagnoses following medication use, although these diagnoses alone do not establish that gabapentin caused the injuries.

In October 2026, reporting identified a Philadelphia state-court mass tort program coordinating product liability cases alleging neurocognitive injuries associated with gabapentin and pregabalin.

Those individual claims differ from a nationwide gabapentin class action lawsuit.

Pfizer and its subsidiaries previously reached Neurontin-related settlements totaling approximately nearly $1 billion, in disputes involving off-label marketing and antitrust allegations.

Those resolutions included a $430 million settlement in 2004, a $325 million settlement concerning third-party payers and a $190 million antitrust settlement.

A federal appellate court also upheld a separate verdict of approximately $142 million involving Kaiser Foundation Health Plan over allegations related to marketing gabapentin for unapproved uses.

These earlier cases concerned marketing practices or economic losses rather than proof of a dementia-related injury, and their outcomes do not establish that gabapentin belongs among medications proven to cause dementia.

Claims involving allegedly dangerous medications require medical evidence and legal analysis specific to the injury.

Readers seeking information about the current allegations, potential eligibility, and evidence can review our gabapentin lawsuit guide.

TorHoerman Law is investigating potential claims involving dementia, mild cognitive impairment, and other serious cognitive injuries allegedly associated with gabapentin use.

Our gabapentin lawsuit lawyers can review prescription histories, medical diagnoses, and other available information to determine whether a claim warrants further investigation.

A diagnosis after gabapentin use does not automatically establish eligibility or manufacturer liability.

If you or a loved one experienced serious cognitive changes after taking gabapentin, contact TorHoerman Law for a free consultation or use our website’s chat feature.

Our firm handles qualifying cases on a contingency fee basis, with no attorney fees unless compensation is recovered.