The recent research on Gabepentin focuses on the off-label use and why it’s becoming a drug of increasing concern for abuse and misuse. Off-label use means the drug is not approved or monitored by the FDA, for the ailment prescribed. The question becomes what is the reason the doctor thinks it will work, do they have patients who have seen improvement and will it help or do harm.
Doctors write prescriptions for off-label conditions on a regular basis and that doesn’t mean you need to pass on taking the medication. There were numerous occasions my Psychiatrist wrote me off-label prescriptions with great success. This is not a make or break decision, it’s a call to gather more information before making your choice.
This is what I gathered through reseach papers and articles.
Gabapentin is widely used in the United States for a number of off-label indications, often as an alternative to opioid therapy. Increasing evidence has emerged suggesting that Gabapentin may not be as benign as once thought and may be associated with substance abuse in concert with opioids. With concerns for safety mounting, it is prudent to examine the efficacy of Gabapentin across its many uses to understand the risk-benefit balance. Reviews on off-label indications such as migraine, fibromyalgia, mental illness, and substance dependence have found modest to no effect on relevant clinical outcomes. This high-quality evidence has often been overshadowed by uncontrolled studies and limited case reports. Furthermore, the involvement of Gabapentin in questionable marketing schemes further calls its use into question. Overall, clinicians should exercise rigorous appraisal of the available evidence for a given indication, and researchers should conduct larger, higher-quality studies to better assess the efficacy of Gabapentin for many of its off-label uses.
Gabapentin may cause breathing problems in people who use opioid pain medicines and those with chronic obstructive pulmonary disease (COPD). Older adults who take Gabapentin are also at a higher risk of breathing problems.
Because Gabapentin can enhance the psychological effect of opioids, it has the potential to be abused and has contributed to drug overdose deaths.
Drugs such as Gabapentin have been linked in rare cases to an increased risk of suicidal thoughts or behaviors. If you take Gabapentin, you or your family should tell the doctor about any unusual changes in your mood, such as agitation, violence, aggression, depression, or talking about wanting to hurt yourself.
Side effects of gabapentin
Common side effects of Gabapentin include:
- drowsiness or dizziness
- headache or blurred vision
- nausea, vomiting, diarrhea, constipation
- dry mouth
- weight gain
- swelling of the hands, feet, or ankles
- back or joint pain
- flulike symptoms such as fever or body aches.
Rare but serious side effects
Rare but serious side effects of Gabapentin include:
- rash, itching, or yellowing of the skin
- swelling of the face and throat, a condition called angioedema
- problems speaking or swallowing
- changes in memory, ability to concentrate, or personality.
Safely stopping treatment with Gabapentin
If you stop taking gabapentin suddenly, there is a chance of having seizures. Instead, you may need to gradually reduce how much Gabapentin you take until you stop it completely. Your doctor can advise you on how to safely stop treatment with Gabapentin.
Several large studies published in 2025 and earlier have tracked patients with ongoing Gabapentin prescriptions. The results were eye-opening. Adults who had six or more prescriptions showed about a 29% higher risk of dementia and an 85% higher risk of MCI compared to people who didn’t take Gabapentin. For those with 12 or more prescriptions, the numbers jumped even higher, roughly 40% greater dementia risk and a 65% increase in MCI. What’s especially surprising is that this wasn’t limited to older adults. Even people under 65, who typically aren’t considered high risk for dementia, seemed more vulnerable.
The cognitive side effects of Gabapentin are often subtle at first but can become harder to ignore with long-term use. Patients have reported memory loss, difficulty concentrating, slower thinking, and that frustrating “brain fog” feeling. Some research suggests these issues can appear within just a week of starting Gabapentin, while other studies found they show up more clearly after extended treatment. Either way, it’s clear that Gabapentin can have an impact on mental sharpness and attention.
Of course, it’s important to keep things in perspective. These studies show an association, not direct proof that Gabapentin causes dementia. Chronic pain itself is known to affect brain health, and many patients on Gabapentin are also taking other medications that could play a role. So while the findings are concerning, they don’t mean every person who takes Gabapentin long-term will develop dementia.
The decision is always your’s to make.
Melinda
References:
https://my.clevelandclinic.org/health/drugs/21561-gabapentin
lookingforthelight.blog 