Gabapentin's Role in Dementia Management

Current Evidence on Gabapentin in Dementia

The American Geriatrics Society recommends that gabapentin lacks FDA approval for the treatment of behavioral and psychological symptoms of dementia (BPSD) and has limited evidence supporting its use in this population 4, 5

The Mayo Clinic Proceedings states that gabapentin, like other antiseizure medications, requires careful tapering when discontinuing to avoid withdrawal symptoms 1, 3
The Mayo Clinic Proceedings also notes that medications with anticholinergic properties, including some antiseizure drugs, can worsen cognitive function in patients with dementia 2, 6

The Journal of the American Geriatrics Society recommends that non-pharmacological interventions should be exhausted before considering any medication for behavioral symptoms in dementia 5, 7
The Journal of the American Geriatrics Society suggests evidence-based non-pharmacological approaches, including caregiver education about dementia and communication techniques, creating meaningful activities and establishing structured routines, environmental modifications to enhance safety and reduce triggers, and addressing underlying medical conditions (pain, infection, etc.) 8

The American family physician notes that cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are FDA-approved for mild to moderate Alzheimer's dementia 9
BioScience Trends indicates that memantine is indicated for moderate to severe dementia 9
The Mayo Clinic Proceedings recommends that for severe behavioral disturbances that pose significant risk, antipsychotics may be considered for short-term use despite risks, but only when patients pose serious risk of harm to themselves or others 1, 3
The American family physician suggests that citalopram and other SSRIs with minimal anticholinergic effects may be appropriate for depression in dementia 7