In December I posted a blog on the risks associated with Gabapentin as it relates to hip fractures, but it may be time to take another look at Gabapentin. The referenced study was conducted in Australia and identified that adults hospitalized for first hip fracture were prescribed this medication. Gabapentin has gotten a lot of bad publicity as research indicates use of this medication is associated with falls and resulting hip fractures, however, these studies have only compared patients prescribed Gabapentin to those who didn’t use medications which may result in an overestimated risk with Gabapentin.

Fast forward 2025! A more recent study published in the Annals of Internal Medicine assessed the risk for falls in older adults after initiating Gabapentin versus Duloxetine (Cymbalta). Both medications are commonly prescribed off-label as a non-opioid alternative for various pain syndromes. This study basically leveled the playing field and prevented bias as there was a comparative medication used.

At the end of the day, compared with Duloxetine, the use of Gabapentin was not associated with increased fall-related visits. Of note, this study did not evaluate the incidence of hip fracture (as referenced in the December blog). Should we take another look at Gabapentin to see if it increases the risk of hip fracture? The jury is out, more studies need to be done, however, it goes without saying that all medications need to be monitored as no medication is without risk. Maybe it is time to have a pharmacy review starting with those residents experiencing an increase in falls! Stay well and stay informed!