Gabapentin is a medication often prescribed to manage nerve pain, seizures, and sometimes anxiety. While it can be effective, elderly patients need to be especially cautious because they are more vulnerable to certain side effects.
One of the most common and concerning side effects in older adults is **dizziness**, which can lead to impaired balance and a higher risk of falls. Falls are a serious issue for the elderly because they can cause fractures and other injuries that may require hospitalization. This risk is increased if the patient is also taking other medications that depress the central nervous system or if they have reduced kidney function, which slows the clearance of gabapentin from the body. Starting with a low dose and gradually increasing it can help reduce this risk[2].
**Drowsiness or somnolence** is another frequent side effect. Older adults may feel unusually tired or sleepy during the day, which can affect their alertness and ability to perform daily activities safely. This sedation can also contribute to the risk of falls and accidents[2][3].
Fluid retention, or **peripheral edema**, is also reported in some elderly patients. This swelling usually occurs in the legs, feet, or hands and can cause discomfort or worsen existing heart or kidney problems[2][4].
Cognitive effects are particularly important to monitor in the elderly. Gabapentin has been linked to problems with memory, confusion, and slowed thinking. Some studies suggest that long-term use, especially with multiple prescriptions, may increase the risk of mild cognitive impairment or dementia. Elderly patients are already at higher risk for neurodegenerative conditions, so any additional cognitive impact from medication should be carefully watched[1][3].
Other side effects that may occur include blurred vision, dry mouth, and coordination difficulties. These can further impair an elderly person’s ability to function independently and safely[3][6].
More serious but less common side effects include mood changes such as anxiety or depression, breathing difficulties (especially if combined with other sedatives or opioids), and allergic reactions. Because gabapentin is cleared by the kidneys, elderly patients with kidney problems need close monitoring to avoid toxic buildup[3][5].
In summary, gabapentin can cause several side effects in elderly patients, with dizziness and drowsiness being the most common and potentially dangerous due to the increased risk of falls. Cognitive impairment and fluid retention are also concerns. Careful dosing, monitoring kidney function, and watching for any changes in mental status or balance are important steps to use gabapentin safely in older adults.
Sources
https://www.aol.com/gabapentin-users-may-face-85-110000239.html
https://medichem-pharmacy.co.uk/what-is-the-biggest-side-effect-of-gabapentin-risks-explained
https://www.renaissancerecovery.com/drug/gabapentin/can-you-overdose-on-gabapentin/
https://www.singlecare.com/blog/does-gabapentin-cause-weight-gain/
https://www.helpguide.org/mental-health/treatment/gabapentin-for-anxiety
https://www.droracle.ai/articles/485346/what-are-the-potential-adverse-reactions-of-gabapentin-neurontin
