Gabapentin and Dementia: Risks, Symptoms and Safety Concerns

Gabapentin is an FDA-approved prescription medicine used to treat nerve pain after shingles and seizures in combination with other medications. Neurontin is the brand-name version currently manufactured by Pfizer’s Viatris Specialty LLC, but it was originally manufactured by Parke-Davis.

The FDA originally approved Neurontin in 1993, but generic gabapentin has been available since 2004.

Depending on the generic manufacturer and the drug label, the indications may differ. For example, gabapentin tablets distributed by Camber Pharmaceuticals, Inc. are not suggested for seizures. It’s important to read the drug label carefully and talk to your doctor about your prescription.

Most recently, a 2025 study published in Regional Anesthesia & Pain Medicine linked gabapentin to an increased incidence of dementia and cognitive impairment.

Gabapentin History and Manufacturers

Warner-Lambert’s Parke-Davis division originally marketed Neurontin. Pfizer acquired Warner-Lambert in 2000.

In 2019, Mylan and Upjohn, a division of Pfizer, formed a new company called Viatris Specialty LLC. This company is the current distributor of Neurontin. Various companies also make generic gabapentin.

Clinicians use Neurontin for two FDA-approved (on-label) uses: nerve pain after shingles (postherpetic neuralgia) and, along with other medicines, to treat partial-onset epileptic seizures. Depending on the company and label, the approved uses for generic gabapentin may differ.

Doctors may also use gabapentin for unapproved uses, called off-label uses, including chronic pain and psychiatric disorders. It’s legal to prescribe drugs off-label, but the FDA has not approved these uses and hasn’t determined whether they are safe or effective.

While doctors are allowed to use drugs off-label, drug companies are not allowed to market or promote them for these uses.

Gabapentin’s History of Off-Label Marketing

Gabapentin has a history of off-label use, and its manufacturers have paid Department of Justice (DOJ) settlements for criminal charges of illegal marketing.

In 2004, Warner-Lambert agreed to plead guilty and pay more than $430 million to resolve criminal charges tied to promoting gabapentin for unapproved uses.

According to the DOJ, Warner-Lambert’s subsidiary Parke-Davis marketed Neurontin off-label for “bipolar mental disorder, various pain disorders, Amyotrophic Lateral Sclerosis (ALS, a degenerative nerve disease commonly referred to as Lou Gehrig’s Disease), attention deficit disorder, migraine, drug and alcohol withdrawal seizures, restless leg syndrome and as a first-line monotherapy treatment for epilepsy.”

Several observational studies have looked for a connection between gabapentin or the broader gabapentinoid drug class (gabapentin and pregabalin) and dementia.

While these studies found a link between gabapentin and increased risk of dementia or cognitive impairment, they do not prove that gabapentin causes these conditions.

The 2025 Regional Anesthesia & Pain Medicine Study

In a 2025 study published in Regional Anesthesia & Pain Medicine, people who received at least six gabapentin prescriptions had a rate of dementia diagnosis that was 29% higher than the group that didn’t take gabapentin in the study. The rate of a mild cognitive impairment diagnosis was 85% higher than in the comparison group.

To estimate incidence rates, researchers used U.S. medical records from 2004 to 2024 to compare 26,414 adults prescribed gabapentin off-label for chronic low back pain with an equal number who were not. The team considered documented demographics, other conditions and use of other pain medicines.

Two other notable studies are a 2023 Taiwanese study and a 2026 review of five observational studies. They found an association between gabapentin and pregabalin and increased dementia diagnoses. However, since these studies analyzed the two medicines together, their results cannot be attributed to gabapentin alone.

Does Gabapentin Cause Memory Loss?

While there isn’t proof that gabapentin causes memory loss, the drug is associated with dementia and mild cognitive problems in studies. The drug’s label says some people in clinical trials reported amnesia and abnormal thinking.

Cognitive Impairment and Brain Fog

“Brain fog” is an informal term for cognitive impairment symptoms that make a person feel less clear-headed, slower to think or unable to concentrate as usual. Brain fog isn’t a diagnosis of a medical condition like the gabapentin-associated cognitive impairment found in studies. However, brain fog symptoms may lead to a diagnosis of cognitive impairment.

The 2025 study found that people who took gabapentin had an 85% increased risk of receiving a mild cognitive impairment diagnosis.

Changes worth discussing with a healthcare professional may include repeatedly losing track of recent conversations, trouble finding familiar words, difficulty following a task that used to be routine, or confusion that others have noticed.

Trouble concentrating, unusual sleepiness and problems with balance can also be important when a person is taking a medicine that affects the nervous system.

Common Symptoms Patients Report

Memory lapses, confusion, disorientation, difficulty concentrating and trouble finding words can be common symptoms of dementia and mild cognitive impairment. Each person is different and any change in the way you or a loved one thinks or feels after long-term gabapentin use could be a warning sign.

In gabapentin clinical trials, patients reported dizziness, abnormal thinking, sleepiness and memory problems (amnesia).

Who Is Most at Risk

People who use gabapentin long term (six or more prescriptions) may have the highest risk of a dementia or mild cognitive impairment diagnosis. The risk was greater among patients aged 18 to 64 and increased with more frequent prescriptions, according to the 2025 study.

Researchers found people in the 35 to 49 year old age group had double the risk of a dementia diagnosis and more than three times the risk of a mild cognitive impairment diagnosis. This group had the highest risk overall. People in the 50 to 64-year-old group had similar results.

People who had 12 or more gabapentin prescriptions were 40% more likely to develop dementia and 65% more likely to develop mild cognitive impairment compared to those prescribed gabapentin between 3 and 11 times.

When to Talk to a Doctor

You should talk to a doctor if you or someone close to you begins to have changes in memory or thinking. This may include forgetting recent events or being unable to think clearly.

Common symptoms to watch out for include memory lapses, confusion, disorientation, difficulty concentrating and trouble finding words. Don’t stop taking gabapentin without talking to your doctor.

There has been no formal recall for gabapentin because of dementia or mild cognitive impairment risks despite concerns raised in studies.

In 2025, a few lots of generic gabapentin capsules were recalled for potential cross-contamination and impurities. However, these recalls aren’t related to dementia or cognitive impairment concerns.

Lawyers are investigating cases on behalf of people who developed dementia, mild cognitive impairment or memory loss after receiving six or more prescriptions of gabapentin. These gabapentin lawsuits are based on allegations that Pfizer failed to properly warn about dementia and cognitive impairment risks.

The 2004 DOJ Neurontin off-label marketing settlement was for criminal charges of illegal marketing and didn’t have anything to do with dementia claims.