Understanding if and why Can Gabapentin Mess With Your Head

October 9, 2025 •

4 min read

According to research published in the journal Regional Anesthesia & Pain Medicine, prescription gabapentin is associated with an increased risk of dementia and mild cognitive impairment, particularly in middle-aged adults, highlighting the question: Can gabapentin mess with your head?. While primarily an anticonvulsant, its effects on the brain can lead to a range of cognitive and psychological side effects that require awareness and monitoring.

Quick Summary

Gabapentin can cause a range of cognitive and mood-related side effects, including brain fog, memory issues, depression, and anxiety, by altering neurotransmitter activity in the brain. Risk factors include dosage, long-term use, age, and drug combinations, with symptoms often improving with dose adjustment or discontinuation.

Key Points

Cognitive Effects: Gabapentin can cause brain fog, memory loss (especially short-term), difficulty concentrating, and slowed thought processing by depressing central nervous system activity.
Psychological Impact: Mood swings, increased anxiety, and new or worsening depression are possible psychological side effects, with suicidal thoughts being a rare but serious risk.
Long-Term Concerns: Emerging research suggests an association between long-term gabapentin use, particularly in middle-aged adults, and an increased risk of mild cognitive impairment and dementia.
Withdrawal Symptoms: Stopping gabapentin abruptly can cause psychological withdrawal symptoms, including severe anxiety, agitation, and insomnia, necessitating a medically supervised tapering plan.
Risk Factors: The risk of mental side effects is higher with increased dosage, prolonged use, advanced age, and when combined with other central nervous system depressants like alcohol or opioids.
Open Communication is Key: Patients experiencing any mental or cognitive side effects should discuss them with their doctor to consider dosage adjustments or alternative therapies, and should never stop the medication suddenly.

The Mechanism Behind Gabapentin's Mental Effects

Gabapentin is a medication used for nerve pain, certain seizures, and restless legs syndrome. It works by affecting the central nervous system to calm overactive nerves. It binds to voltage-gated calcium channels, which impacts the release of excitatory neurotransmitters like glutamate. This action slows down brain signaling, helping with pain but potentially causing cognitive and psychological effects. Gabapentin may also increase the calming neurotransmitter GABA, contributing to sedation and potentially interfering with mood regulation. This can lead to mood changes like depression or anxiety. The combination of reduced nerve activity and altered neurotransmitter balance explains how gabapentin can affect mental clarity and mood.

Cognitive Side Effects: Brain Fog, Memory, and More

Gabapentin can cause cognitive issues, often described as 'brain fog'. Common cognitive side effects include difficulty concentrating, slower thinking, memory problems (especially short-term), difficulty with planning, dizziness, and drowsiness. Studies suggest a link between long-term gabapentin use and an increased risk of dementia and mild cognitive impairment (MCI), particularly in middle-aged adults. A study found that frequent prescriptions were associated with a higher risk of MCI and dementia. These findings highlight the need to monitor cognitive function in patients on long-term gabapentin.

Psychological and Mood-Related Side Effects

Gabapentin can also affect psychological well-being and mood. Possible effects include new or worsening depression, anxiety, agitation, restlessness, and irritability. In rare cases, anticonvulsants like gabapentin have been linked to an increased risk of suicidal thoughts or behaviors, which can occur soon after starting the medication. Children may be particularly susceptible to mood swings and irritability.

Factors Influencing Mental Side Effects

Several factors affect the likelihood and severity of gabapentin's mental side effects:

Dosage: Higher doses tend to increase cognitive impairment and other adverse effects.
Duration of Use: Long-term use is associated with potential cognitive decline and may worsen mood disorders.
Age: Older adults and middle-aged individuals, particularly those over 65, may face a higher risk of cognitive side effects.
Co-administered Drugs: Combining gabapentin with other CNS depressants like opioids, benzodiazepines, or alcohol significantly increases the risk of sedation, confusion, and other serious side effects.
Pre-existing Conditions: A history of mental health or neurological issues can make individuals more vulnerable to adverse psychological effects.
Abuse and Dependence: Misusing gabapentin can lead to severe psychological effects and dependence. Abruptly stopping high doses or long-term use can cause withdrawal symptoms like anxiety, agitation, and confusion.

Comparing Cognitive vs. Psychological Side Effects


Feature	Cognitive Side Effects	Psychological Side Effects
Mechanism	Caused by gabapentin's general central nervous system depression and influence on neurotransmitters like glutamate and GABA.	Result from the drug's impact on neurotransmitter balance, particularly serotonin and GABA pathways.
Common Examples	Brain fog, memory loss (short-term), difficulty concentrating, slow thinking, dizziness, impaired coordination.	Mood swings, anxiety, irritability, restlessness, depression.
Severity	Often mild-to-moderate and may improve over time or with dosage adjustments. Can be more severe with high doses or in sensitive populations.	Can range from mild mood changes to severe depression or suicidal thoughts, especially with pre-existing conditions or abuse.
Reversibility	Usually reversible upon discontinuation or dose adjustment. Long-term risks like dementia are still under investigation.	Generally resolves after stopping the medication, but abrupt withdrawal can cause rebound psychological symptoms.
Risk Factors	Higher dose, older age, long-term use, combination with other CNS depressants.	Higher dose, history of mental health issues, use with other CNS depressants, long-term use.

What to Do If You Experience Mental Side Effects

If you experience mental side effects from gabapentin, it's essential to talk to your healthcare provider. Do not stop taking the medication suddenly due to the risk of severe withdrawal symptoms. Track your symptoms, including changes in mood, memory, or cognitive function, noting when they occur and their relation to your dosage. Discuss these concerns with your doctor to explore potential dosage adjustments or alternative medications. Inform your doctor about all other medications and supplements you take, as interactions can worsen side effects. If mood changes are a primary concern, your doctor might suggest therapy or stress-reduction techniques.

Conclusion: Balancing Risks and Benefits

Gabapentin can indeed cause cognitive and psychological side effects, ranging from mild brain fog and drowsiness to more significant issues like depression, anxiety, and memory impairment. Its impact on the central nervous system makes these mental changes possible. Factors like dosage, duration of use, age, and other medications influence individual risk. Research linking long-term use to increased cognitive decline highlights the need for careful monitoring. Deciding to continue gabapentin should involve close consultation with a healthcare provider, balancing the medication's benefits with its potential effects on mental well-being. Open communication and symptom tracking are vital. Resources like the Mayo Clinic can provide additional information on drug-related side effects.

Frequently Asked Questions

Gabapentin brain fog is often described as a general mental fogginess, slow thinking, difficulty concentrating, and impaired memory. Patients may feel less sharp or struggle with tasks that require significant mental effort.

Yes, gabapentin can cause or worsen depression and anxiety in some individuals. Mood changes, including irritability and sadness, are possible side effects. Those with a pre-existing history of mood disorders may be at higher risk.

For most people, memory problems caused by gabapentin are temporary and can improve once the dosage is reduced or the medication is stopped. However, some long-term studies suggest an increased risk of cognitive decline with long-term use, especially in older adults.

Older adults, individuals taking higher doses, those on long-term therapy, and people who combine gabapentin with other central nervous system depressants are at a greater risk of experiencing cognitive side effects.

If you notice changes in your mental state, you should contact your healthcare provider immediately. Do not stop the medication on your own. Your doctor can evaluate your symptoms and determine if a dosage adjustment or alternative treatment is necessary.

Yes, abrupt cessation of gabapentin, particularly after prolonged or high-dose use, can cause psychological withdrawal symptoms. These can include severe anxiety, agitation, irritability, and insomnia.

Gabapentin works by altering neurotransmitter activity in the brain, including modulating calcium channels and potentially increasing GABA levels, which calms nerve activity. This central nervous system depression, while treating conditions like nerve pain, can also lead to changes in cognition and mood.