Risk of dementia following gabapentin prescription in chronic low back pain patients | Regional Anesthesia & Pain Medicine
Study Sheds New Light on Gabapentin Risks | MedPage Today
Dementia incidence higher for younger chronic back pain patients prescribed gabapentin
Key Takeaways
- Gabapentin prescriptions for chronic back pain were linked to higher dementia and cognitive impairment risk.
- Risks were especially high for chronic back pain patients ages 35 to 64.
- The study highlights potential concerns in light of increasing off-label use of gabapentin.
Results 26,416 adults we analyzed following propensity-score matching. Patients with six or more gabapentin prescriptions had an increased incidence of dementia (RR: 1.29; 95% CI: 1.18–1.40) and mild cognitive impairment (RR: 1.85; 95% CI: 1.63–2.10). When stratified by age, non-elderly adults (18–64) prescribed gabapentin had over twice the risk of dementia (RR: 2.10; 95% CI: 1.75–2.51) and mild cognitive impairment (RR: 2.50; 95% CI: 2.04–3.05) compared to those not prescribed gabapentin. Risk increased further with prescription frequency: patients with 12 or more prescriptions had a higher incidence of dementia (RR: 1.40; 95% CI: 1.25–1.57) and mild cognitive impairment (RR: 1.65; 95% CI: 1.42–1.91) than those prescribed gabapentin 3–11 times.
Conclusions Gabapentin prescription in adults with chronic low back pain is associated with increased risk of dementia and cognitive impairment, particularly in non-elderly adults. Physicians should monitor cognitive outcomes in patients prescribed gabapentin.
Initiation of Pregabalin vs Gabapentin and Development of Heart Failure | Cardiology | JAMA Network Open | JAMA Network
https://www.medpagetoday.com/cardiology/chf/116783
- Question Is pregabalin associated with higher incidence of heart failure (HF) compared with gabapentin?
- Findings In this cohort study of 246 237 Medicare beneficiaries aged 65 to 89 years with noncancer chronic pain, pregabalin was associated with a higher incidence of HF compared with gabapentin.
- Meaning The findings suggest that pregabalin should be prescribed with caution in older patients with noncancer chronic pain.
Are Gabapentinoids Effective at Reducing Pain and Improving Sleep After Nerve Injury? A Systematic Review and Meta-analysis
Conclusion
The best available evidence, now consisting of four RCTs, suggests that gabapentinoids should not be used to reduce pain intensity or sleep disruption in patients with peripheral nerve injuries, especially given their substantial side effects and potential for misuse.