A new study published in the Annals of Internal Medicine indicates that gabapentin, a widely prescribed medication for chronic and nerve pain, does not increase the risk of falls in elderly patients. This finding challenges previous concerns and suggests gabapentin may be a safer option for pain management in seniors than initially thought.
The research, led by Dr. Alexander Chaitoff from the University of Michigan, compared gabapentin to duloxetine, another drug used for nerve pain, in a cohort of over 57,000 seniors aged 65 and older. Data were collected between January 2014 and December 2021, focusing on patients prescribed either medication for nerve pain related to conditions like diabetes, shingles, or fibromyalgia.
Key Findings on Fall Risk
The study revealed that seniors taking gabapentin had a 48% lower overall risk of any falls compared to those taking duloxetine. Furthermore, the study found no difference in the risk of severe falls between the two groups. This suggests that gabapentin does not increase the risk of serious fall-related injuries in this population.
"Although we cannot claim that gabapentin does not lead to higher risk for falls at any time, our study does suggest that the risks of gabapentin as they relate to fall risk in the first 6 months of initiation are not greater, or potentially favorable, versus an alternative medication that might be prescribed instead," the research team concluded.
Context and Implications
Gabapentin is frequently prescribed as an alternative to opioid painkillers, with nearly 50 million prescriptions written in 2020. However, concerns about potential fall risks led to a 20% decrease in prescriptions by 2022. Chaitoff and his team hypothesized that the painful conditions for which gabapentin is prescribed might independently increase fall risk, potentially skewing previous findings.
Study Design and Methodology
The study addressed this by comparing gabapentin to duloxetine, a drug without the same reputation for increasing fall risk. By analyzing data from a large cohort of seniors, the researchers were able to assess the relative risk of falls associated with each medication. The primary outcome measured was the incidence of falls requiring healthcare visits.
Considerations for Prescribers
The study's findings suggest that concerns about gabapentin's impact on fall risk in seniors may have been overstated. Dr. Chaitoff's team suggests that these findings should be considered when discussing treatment options with patients considering gabapentin for pain management. While the study provides valuable insights, clinicians should continue to evaluate individual patient risk factors when prescribing gabapentin.
