- An opioid drug called gabapentin is approved for the treatment of shingles-related pain and seizures in the United States. Off-label, it is also used for treating low back pain and other conditions.
- Additionally, using gabapentin may increase a person’s risk of dementia and cognitive impairment, according to previous research.
- People prescribed gabapentin for lower back pain six times or more are more likely to have mild cognitive impairment and dementia, a recent study has shown.
- These risks were more than doubled among adults aged 35 to 49, researchers report.
The US Food and Drug Administration (FDA) has approved gabapentin as a drug for moderate-to-severe restless leg syndrome, postherpetic neuralgia (an underlying nerve pain associated with shingles), and a small number of epileptic seizures.
Gabapentin is also occasionally prescribed as an off-label treatment for akathisia, alcohol use disorder, anxiety disorders, insomnia, hot flashes, diabetic peripheral neuropathy and lower back pain.
Gabapentin has several potential adverse effects, like: fatigue, dry mouth, water retention, and dizziness, just like any other medicine. Also, some previous research has shown that taking gabapentin may cause respiratory problems ( [ reliable source ] ). It also has the potential to increase the risk of developing dementia and cognitive impairment.
People who take gabapentin for pain in the lower back six times or more are more likely to develop dementia and moderate cognitive impairment (MCI), according to a review published yesterday in the journal Regional Anesthesia & Pain Medicine. Risks were also more than doubled among adults aged 35 to 49, researchers have found.
How does gabapentin impact the risk of dementia and MCI?
For this study the researchers compared data from more than 26, 000 participants from the federated health research network TriNetX.
The researchers recruited patients with a chronic pain diagnosis, chronic pain syndrome, lumbar radiculopathy or persistent low back pain. The study participants were also included in the following age groups: 18–64 years, 18–34 years, 35–49 years, 50–64 years and 65 and older.
They look at the 10-year outcomes of people who take part in the study to figure out the proportion of people who either get dementia in general or Alzheimer’s disease, vascular dementia or MCI in particular.
Nafis B. Eghrari, a fourth year medical student in the Case Western Reserve University School of Medicine in Cleveland, OH and the first author of the study, told Medical News Today there is now some disagreement as to whether taking gabapentin increases the risk of dementia in patients.
Also, there is no known effect of gabapentin on cognition and whether it is involved in neurodegenerative processes; the data from previous studies on this subject have been inconsistent, so we decided to investigate this incompatibility in our work, ” Eghrari added.
The risk of MCI is increased by 85% when you get 6 or more gabapentin prescriptions.
After statistical analysis, the researchers found study participants who received six or more doses of gabapentin were 85 per cent more likely to develop MCI and 29 per cent more likely to develop dementia.
“This data is significant because it shows that on a statewide level there’s a correlation of Gabapentin prescriptions and dementia, ” Eghrari said. “We need more information on the long-term implications of the drug, even though it doesn’t show any causation.
”Practically speaking, “I recommend doctors who prescribe gabapentin for chronic pain periodically do cognitive tests when they meet patients, ” he said.
Additionally, the study recommended that individuals taking this drug inform their doctor if they experience any cognitive issues, such as disorientation, memory loss, or slowed thinking.
What are the disadvantages of research involving enormous datasets?
MNU had a chance to talk to Neel Anand, MD, MCh Orth, head of the Cedars-Sinai Spine Center in Los Angeles and board certified orthopedic spine surgeon.
There are advantages and disadvantages for such studies involving large data sets, since multiple factors can be introduced and there could be difficulty in deciding the exact cause, Anand, who was not involved in the study, told AFP.
Other medical conditions and drugs of interest of the participants were either not included at all or just referred to in passing.
“The major lesson I would take away from the study is [… ] [that] every medication is going to have some problems; there is not a single medication that has no side effect, ” Anand said. “There is a good chance that something goes wrong somewhere if you are going to be taking something on a regular basis.
“According to Anand, “the most direct way to prove anything is to compare a cohort of research participants who take just one drug and nothing else with another cohort who don’t take the drug. ” And if participants are given medication (which they are supposed to take), researchers need to be sure that the participants have taken that medication.
Sometimes people don’t follow their doctor’s instructions when taking prescription drugs, he added.
“They don’t take less sometimes, and sometimes they take more, ” said Anand. “The only way to really study [the real-life consequences of drug use for extended periods] is to actually take a thousand people and give them Gabapentin and nothing.
