bumbledraven8 hours ago
Absolutely no causal link was shown. Maybe the nerve pains for which doctors prescribe gabapentin increase the risk of dementia on their own, or maybe there is some third factor that causes both nerve pain and dementia.
pgreenwood7 hours ago
Not sure why this comment is getting downvoted. The article itself states that:
> "This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. The researchers also acknowledge that their study was retrospective, and they weren't able to account for dose or length of gabapentin use."
bitmasher97 hours ago
Not to be too meta, but it’s kind of boring to point out the obvious limitation of the research method.
“No casual link is proven” could be said about so much science, specifically medical science and other disciplines which limit research methods for ethical or practical constraints. So you end up with this comment in every front page post about an observational medical study. We could be discussing the actual research or its implications, instead of repeating a discussion on limitations of research methodology.
In addition, I find these types of critics to be a little too cynical even for my taste. There’s a whole group of people that feel smart by finding ways to dismiss scientific studies even when there is some actually interesting data being brought up.
MobiusHorizons6 hours ago
On first brief reading I misunderstood the title to be causal, even though it only claims a link. I think it is worth pointing out for those who check the comments before reading.
Edit: clarity
Footkerchief5 hours ago
Yes, these comments are necessary pushback against the habit of these disciplines to push interventions that don't work because their evidentiary standards are bad.
colechristensen7 hours ago
in this study it was linking prescriptions given for back pain
Perenti5 hours ago
I've taken quite a lot of these. I was on 3600mg/day for about 5 years. I was later on lyrica for about 3 years.
These drugs _do_ help you to tolerate nerve pain, but do _not_ stop it. I found they led to my otherwise amazing memory developing "holes" - I knew I knew something, but I couldn't put my finger on it. As someone accused of having an eidetic memory (I'm not convinced) I found this really disturbing. I also felt more stupid, and less quick.
I've been off gabapentinoid medications for about 4 years. My pain is more "in my face", but I no longer feel retarded.
Note: The advice on the gabapentinoid box "May increase the effects of alcohol" is both warning and recommendation. It's not unknown for the mix to include open-eyed hallucinations.
burnt-resistor3 hours ago
Holy! 3600mg is a lot-a lot.
GABA analogues are known to impact memory formation.
stacktrust3 hours ago
The widespread use of Gabapentin and Pregabalin to treat neuropathy is off-label their original function as anti-convulsant and anti-psychotic meds. In addition to the documented negative side effects, withdrawal by elderly patients from extended use can be difficult, even with months of tapering. They can negatively affect memory and cognition.
https://en.wikipedia.org/wiki/Gabapentin
> Gabapentin, sold under the brand name Neurontin among others, is an anticonvulsant medication primarily used to treat neuropathic pain and also for partial seizures of epilepsy.. is [ONLY] moderately effective: about 30–40% of those given gabapentin for diabetic neuropathy or postherpetic neuralgia have a meaningful benefit.
Those with peripheral neuropathy should audit the total amount of Vitamin B6 in their diet and daily supplements. Try to keep the daily amount below 10mg. There have not yet been lawsuits to add bottle label warnings, but Australian regulators have issued a safety warning.
https://www.tga.gov.au/news/safety-alerts/health-supplements...
> Vitamin B6 (pyridoxine) is in lots of multivitamin and mineral supplements that can be bought in supermarkets, health food shops and pharmacies without a prescription. Many people are not aware that vitamin B6 can cause peripheral neuropathy, which results in tingling, burning or numbness usually in the hands and feet. Taking vitamin B6 even at low doses can cause peripheral neuropathy but people are more likely to get it if they are taking more than one supplement.
VoidWhisperer6 hours ago
When they say given 'x number of prescriptions of gabapentin', what does a prescription actually mean dosage and length wise?
I would love more info on this because I have been taking gabapentin for years due to nerve damage from having Guilliane-Barre syndrome.
Edit: Re-reading the article, i see 'The researchers also acknowledge that their study was retrospective, and they weren't able to account for dose or length of gabapentin use.' - this seems like a pretty gaping hole in trying to draw an kind of conclusion from this
CobaltFire6 hours ago
I tried looking this up, and they don't say anywhere what they mean by prescription. Mine are 90 days, so I want to assume thats normal but don't honestly know. Looking up dosing it seems that 3x300mg is as small as is prescribed, and it can go up to 3x1200mg.
Then we have the increase in incidence. The incidence rate is already small in those age groups, so even doubling it is a tiny number.
I'm going to stop taking it (I take something between 1/10 and 1/5 of my prescribed dose anyhow) and think about if the benefit to me is worth the added risk.
protocolture6 hours ago
My mates on something for nerve pain, and he reckons its the worst thing in the world. Makes him vomit.
So he takes pills for nausea that make him extremely drowsy.
So then he takes uppers, which bring back the nerve pain.
Cool study, I will share it with him. But I get the impression that he would prefer to be demented than paralysed with never pain.
AStonesThrow5 hours ago
[dead]
tptacek6 hours ago
This is a hugely widely-prescribed drug, generally considered extraordinarily well tolerated, so whatever impact gabapentin has on dementia, the effect would have to be pretty small --- in particular: there's no spike that tracks the point at which it started become so widely prescribed.
somenameforme6 hours ago
This wouldn't necessarily be expected for the same reason that if one looked at new smokers after 10 years, there'd be no significant spike in lung cancer. This is what makes long terms effects of things so difficult to prove. Even tylenol/paracetomol is still having some interesting new discoveries made. This is the main reason I tend to strongly adhere to the precautionary principle when it comes to any sort of "new" drug.
tptacek6 hours ago
It's been like 30 years. We'd see it, if there was a significant effect.
azinman25 hours ago
What’s happening with Tylenol?
jpease5 hours ago
As results are quantified by number of “prescriptions”, and 6 prescriptions of n pills at a given dosage presumably increase risk over 1 prescription of 6(n) pills, then they’ve clearly proven the risk factor is going to the pharmacy.
viccis5 hours ago
It cured my cat's hyperesthesia so lil guy is gonna stay on it.
ykonstant3 hours ago
By "cured", you mean mitigated, right? Otherwise you would not need to keep administering it.
AStonesThrow5 hours ago
[dead]
burnt-resistor3 hours ago
This might not be good. My mom takes a bunch of it for post-stroke syndrome/neuropathic pain. She reports taking too much feels like being tired/drunk.
CobaltFire7 hours ago
Well damn. I take this as needed for a back injury that left me with chronic pain. My prescription is for a LOT more than I take (I take it about 20% as often as prescribed).
Now I'm not so sure I want to take it. My saving grace is that I'm on the younger end and haven't taken it that long.
After reading the paper and looking into dosing I learned that I'm taking a tiny fraction of the normal dose. Wow. Learn something every day.
555557 hours ago
Also true for benzos. Basically messing with GABA system seems to do this.
jordan_curve6 hours ago
The connection for benzos is somewhat tenuous in its own right, but gabapentin actually has basically nothing to do with Benzos and does not act on your GABA system
floam5 hours ago
I believe gabapentin was once believed to be a positive allosteric modulator (PAM) on certain GABA, and now they don’t even believe that to be the case but it somehow affects GABA expression and activity indirectly. (It’s definitely not a GABA agonist.)
It is also not very potent but there is another drug that shares its mechanism that is potent in single digit mg amounts: pregabalin (Lyrica). It is potent and kinda sorta abusable (not really) and they both can produce a super mild but benzo-ish sedation for a couple hours for a day or two.
It is apparently a coincidence that the drug seemed to resemble GABA and got its name though. Strange.
555556 hours ago
Okay, thank you, I assumed it worked on GABA due to it being named gabapentin and because of its potential for abuse. I've just always assumed that taking drugs that make you less smart acutely might indeed make you less smart over the long-term too. I've known people who would take Gabapentin for a minor high.
burnt-resistor3 hours ago
Gabapentin can lead to dissociative, intoxicated-like, sedentary-like, and confusion-like state. It also partially/theoretically impairs long term memory formation similar to Ambien. I bet OD also leads to hallucinations.
burnt-resistor3 hours ago
~~[EDIT: sed s/.*//] -> Benzos are anticholinergic though. I don't see gabapentin listed as such.]~~
Ey7NFZ3P0nzAe3 hours ago
Wait what? Benzos are not anticholinergic in any sense of the word that I know of.
burnt-resistor3 hours ago
My bad, I'm smoking the proverbial crack. Benzodiazepine addiction => fucks up the GABA system. Anticholinergic, anti-dopaminergic, and GABAnergic breaks different delicate bits.
andrewinardeer6 hours ago
My dog is on this. I wonder if it affects canines?
tguvot5 hours ago
our vet recently prefers to prescribe Pregabalin instead of gabapentin
acomjean8 hours ago
eeep. We just gave this to our dog after knee surgery.
sonofhans7 hours ago
Careful. It might drool all over, develop an unhealthy fascination with squirrels, or randomly forget its own name :D
ykonstant3 hours ago
Oh no! ...wait.
duskwuff7 hours ago
A short course of the medication for post-surgical pain is unlikely to be a serious risk, either in humans or dogs. The patients in the study were taking the drug over a long period of time (months or years) for chronic pain.
PaulHoule7 hours ago
Had it added to paroextine by a psych nurse after finishing a project for the boss from hell. Had the kind of diffuse chronic pain associated with depression and Kohut's "triple split" personality organization which I knew I had then but didn't know why
https://mastodon.social/@UP8/111687412198643478
Can't say gabapentin really helped with the pain but I sure slept well and...
I had terrible social anxiety earlier in my life but in this phase I was getting up every morning and calling people up and down the east coast first thing and working my way to the west coast with my BD guy, never sold anything but boy people told us a lot of things they shouldn't have told us (e.g. EADS was way over its head in a project for the NSA) and I can't go to my grave and say I didn't give a serious try for the idea I had.
Settled in a real job in a real office, doc said I should try quitting paroxetine. Wasn't hard at first but there was that day I got furious about the messes in the house and got 40,000 steps cleaning without going outside and that time I got a psychogenic fever and lost 15 pounds in 3 weeks and kept it off for a year. Then that guy in the upper left corner of that card went through a series of transformations like a character in an anime: first a cute little bunny, then an ugly thing the size of a large bear, then a giant robot maybe 30 feet tall, finally a Godzilla kind of creature maybe 300 feet tall. He posted plenty on HN using my account and made trouble for myself and other people until a crisis broke and I was like "WTF happened there?" and kinda retreated for a year until Lezengreber's book fell into my hand and revealed how I was different from other people (schizotaxia) and why I had that triple split.
If anything good came out of that time it was that I learned my chronic pain was due to TMJ and managed it and now my jaw bugs me maybe one day a month.
Quit smoking pot, had trouble sleeping, would get up in the morning and experience "paranoia towards objects" and have plates jump out my hands like a ouija board and bonk my head four times in a row getting something out of the fridge, it seemed like my wife was always trying to stand exactly where I was going to go next when I was getting ready in the morning. Presented really bad at my doc and got put on a tiny dose of quietapine at night. Helped with the sleep and had only one little bit of 'psychosis' since and been very easy to live with.
I've been worried about the long term effects of gabapentin so I have been backing off my dose. I'm worried about the quietapine too for that matter.
Got friends though who take benzodiazepines for anxiety and those look really dreadful. That really arrests your development, people like that will have the same conversation with you that they had 12 years ago and at least I am not like that.
I know someone who made it to 92 or so with dementia and he was a really nice guy who was totally confused but good natured and easy to live with. My worst fear is that I lose my compensation for my schizotypy (verbal IQ too high to measure really seems to help with that) when I get older and get really paranoid and mean so I do try to develop habits of benevolence but I don't have the deep practice that guy had.
Can say though that I have zero anxiety now I feel like I am an expression of a principle and, on a certain level, can't be defeated. Don't know how much is the meds and how much is maturity.
moomoo118 hours ago
Gave to my cat when we flew. It was not pleasant mainly because it didn’t work.
Yizahi5 minutes ago
It work for cats, but not equally for all, some are less responsive. Also, maybe I will say obvious things, but - cats require bigger dose per kilo than dogs, vet doctor can calculate it for you; and it is advised that you start giving it to cat a day in advance.
mordechai90007 hours ago
I would give it to my dogs a couple times a year in anticipation of fireworks. It worked wonders in their case.
bentt6 hours ago
This was already a scary drug. Was given it for back pain and looked up the side effects. No thanks.
ecwilson6 hours ago
Medical journalists are incentivized to make you concerned. I highly suggest all medical journalism be run through a good AI to be put into context.
https://chatgpt.com/share/68709753-d2ec-8010-ba8b-e7b57d610e...
TLDR:
The paper offers an interesting signal that heavy gabapentin prescribing tracks with higher dementia/MCI diagnoses, especially in 35-64-year-olds. Yet substantial unmeasured confounding, possible reverse causality, and modest absolute risk increments mean we’re far from proving gabapentin is neurotoxic. It’s a reminder to prescribe purposefully, review regularly, and keep cognition on the monitoring checklist—but not a reason for abrupt discontinuation in patients who benefit.