Gabapentin is one of those medications many people are given for pain, nerve problems, shingles pain, restless legs, seizures, or chronic back issues.
And for some people, it can be genuinely helpful.
But in recent years, more patients have started asking an important question:
Could gabapentin affect the brain, memory, or long-term cognitive health?
This question became louder after research linked gabapentin prescriptions with higher rates of mild cognitive impairment and dementia diagnosis in certain groups, especially people using it repeatedly for chronic low back pain. A 2025 medical-records study reported that adults with chronic low back pain who received six or more gabapentin prescriptions had higher dementia and mild cognitive impairment risks over 10 years, although the study showed association, not proof of causation.
So let’s be clear from the beginning:
Do not stop gabapentin suddenly without medical guidance.
Gabapentin can cause withdrawal symptoms and may be dangerous to stop abruptly, especially if you take it for seizures.
But if you or someone you love is taking gabapentin and noticing brain fog, confusion, dizziness, poor balance, memory problems, or extreme fatigue, it is worth having a serious conversation with your doctor.
What Is Gabapentin?
Gabapentin is a prescription medication originally developed for seizures. It is also commonly used for nerve pain, including post-shingles nerve pain, and it is often prescribed off-label for chronic pain conditions.
It works by calming overactive nerve signaling. That is why it may reduce nerve pain, burning, tingling, shooting pain, and seizure activity.
But because it acts on the nervous system, it can also affect the way some people feel mentally and physically.
Common Gabapentin Side Effects
Gabapentin side effects can vary from mild to severe.
Commonly reported side effects include:
Drowsiness
Dizziness
Fatigue
Poor coordination
Brain fog
Blurred vision
Swelling in the legs or feet
Weight gain
Nausea
Unsteadiness
Memory or concentration problems
These effects may be more noticeable in older adults, people taking multiple medications, people with kidney problems, or people combining gabapentin with sedatives, opioids, alcohol, sleep medication, or anti-anxiety drugs.
This matters because dizziness, sleepiness, and poor coordination can increase the risk of falls — especially in older adults.
The Dementia Question: What Did the Research Find?
A 2025 study published in Regional Anesthesia & Pain Medicine looked at medical records of adults with chronic low back pain and compared people prescribed gabapentin with matched controls. The study found that people with six or more gabapentin prescriptions had a 29% higher risk of dementia diagnosis and an 85% higher risk of mild cognitive impairment diagnosis within 10 years.
Another earlier study examining gabapentin or pregabalin found an association between these medications and increased dementia risk, with authors advising caution, especially in susceptible patients.
But this is extremely important:
Association does not prove gabapentin causes dementia.
Experts responding to the 2025 study pointed out that the research was observational. That means it can show a link, but it cannot prove the medicine directly caused cognitive decline. Some risk may be related to the underlying pain condition, poor sleep, reduced activity, depression, other medications, or health issues that were not fully measured.
Still, the signal is important enough that patients should be monitored — especially with long-term use.
Why Gabapentin May Affect Memory and Thinking
Gabapentin calms nerve activity. For someone with severe nerve pain, that may bring relief. But in some people, this calming effect may feel like mental slowing.
People sometimes describe it as:
“My head feels cloudy.”
“I forget words.”
“I feel spaced out.”
“I’m dizzy and tired all day.”
“I don’t feel mentally sharp.”
“I feel off balance.”
This does not automatically mean dementia. Sometimes it is a medication side effect that improves when the dose is adjusted or the medication is changed.
But persistent cognitive symptoms should never be ignored.
Who May Be More Sensitive to Gabapentin?
Some people may be more vulnerable to side effects.
Higher-risk groups include:
Older adults
People with kidney disease
People taking opioids
People taking sleeping pills or benzodiazepines
People drinking alcohol
People taking multiple prescriptions
People with balance problems
People with existing memory concerns
People using gabapentin long term
People taking high or frequent doses
Gabapentin is cleared largely through the kidneys, so kidney function matters. If the kidneys are not clearing it well, the medication may build up and cause more side effects.
Warning Signs to Discuss With Your Doctor
Contact your healthcare provider if you notice:
New confusion
Memory decline
Worsening brain fog
Extreme sleepiness
Falls or poor balance
Mood changes
Depression or suicidal thoughts
Swelling in legs or feet
Trouble breathing
Severe dizziness
Difficulty functioning normally
Feeling sedated all day
Seek urgent help if there is trouble breathing, severe allergic reaction, severe confusion, fainting, or suicidal thoughts.
Do Not Stop Gabapentin Suddenly
This is one of the biggest mistakes people make after reading scary headlines.
Stopping gabapentin suddenly can trigger withdrawal symptoms and may worsen seizures in people who take it for seizure control.
Instead, ask your doctor:
Do I still need gabapentin?
Is my dose too high?
Could it be causing brain fog?
Can we check kidney function?
Are there safer alternatives for me?
Could I taper slowly if appropriate?
Am I taking other sedating medications?
What should we monitor over time?
A careful medication review can often reveal safer options.
Natural Support for Nerve Pain and Brain Health
Natural remedies should not replace prescribed medication without medical guidance, but they may support the body alongside professional care.
For nerve and brain support, focus on the foundations.
Magnesium-rich foods may support muscle and nerve function: pumpkin seeds, spinach, almonds, black beans, avocado, and dark chocolate.
Omega-3 foods support inflammation balance and brain health: sardines, salmon, walnuts, chia seeds, flaxseed, and hemp seeds.
B vitamins, especially B12, B6, and folate, are important for nerve function. Low B12 can mimic nerve problems and cognitive issues, so testing may be helpful.
Anti-inflammatory herbs and spices such as turmeric, ginger, rosemary, garlic, and green tea may support overall inflammation balance.
Blood sugar control matters because high blood sugar can damage nerves and worsen neuropathy.
Gentle movement improves circulation, mood, blood sugar, and brain function. Even walking can help.
Sleep quality is critical. Pain, poor sleep, and sedating medications can create a cycle of exhaustion and brain fog.
Helpful Tests to Ask About
If you are taking gabapentin and feel mentally foggy or physically unsteady, consider asking your healthcare provider about:
Kidney function
Vitamin B12
Vitamin D
Thyroid function
Blood sugar / HbA1c
Iron / ferritin
Medication interactions
Cognitive screening if memory issues persist
Sometimes “medication brain fog” is not one thing. It may be a combination of low nutrients, poor sleep, chronic pain, inflammation, stress, and medication burden.
The Herbalist’s Perspective
From a naturopathic point of view, pain is a message — but so is brain fog.
The goal is not to fear every medication. Sometimes medication is necessary and life-changing. The goal is to use it wisely, monitor it carefully, and support the body so medication is not doing all the work alone.
A strong natural foundation includes:
Whole foods
Protein at every meal
Minerals
Hydration
Daily walking
Nervous system calming
Anti-inflammatory spices
Stable blood sugar
Restorative sleep
Regular medical review
Your brain and nerves need nourishment, not just symptom control.
Final Thoughts
Gabapentin may help many people, especially those with nerve pain or seizures. But it can also cause side effects like dizziness, drowsiness, poor coordination, and brain fog.
New research has raised concerns about a possible association between repeated gabapentin prescriptions and higher rates of dementia or mild cognitive impairment diagnosis. This does not prove gabapentin causes dementia, but it does mean long-term use deserves careful monitoring.
The key message is simple:
Do not panic. Do not stop suddenly. Do not ignore symptoms.
Talk to your doctor. Review your medications. Ask about your dose. Check your kidneys. Support your brain naturally. And pay attention if your memory, balance, or energy begins to change.
The safest medicine is not always the one we never question.
It is the one we use with wisdom.
