The Hidden Dangers of Gabapentinoids in Older Adults: From Accelerated Cognitive Decline to Withdrawal-Induced Neurotoxicity.

Chronic gabapentinoid use in older adults may accelerate cognitive decline, while abrupt discontinuation can trigger a "glutamate storm." This case of a 94-year-old female demonstrates that withdrawal-induced neurotoxicity manifests as severe hyperactive delirium, highlighting the need for cautious prescribing and ultra-slow tapering to protect vulnerable geriatric brains.