Is Gabapentin Effective for Smoking Cessation?

Gabapentin does not appear to be effective for helping people quit smoking based on the best available clinical evidence. In a randomized, placebo‑controlled study, gabapentin did not improve quit rates and did not reduce smoking more than placebo, suggesting it holds little promise as a treatment for tobacco dependence. ^{[1] [2]}

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What the Evidence Shows

Randomized clinical trial (proof‑of‑concept):

• Adults seeking treatment for tobacco dependence were randomized to gabapentin (600 mg three times daily or 900 mg three times daily) or placebo. ^[1]
• After titration, treatment continued for 9 weeks, then tapered for 1 week, with follow‑up for 12 weeks post‑medication. ^[1]
• Key findings: Quit (abstinence) rates were lower in the gabapentin groups than placebo, though not significantly; overall smoking reduction occurred in all groups without differences between gabapentin and placebo. ^{[1] [2]}
• Interpretation: These dosing regimens of gabapentin showed little promise for treating tobacco dependence. ^{[1] [2]}

Related agent (pregabalin):

• Pregabalin did not reduce smoking behavior compared with placebo in a crossover study. ^[3]
• It modestly eased some withdrawal symptoms (anxiety, irritability, frustration) but did not improve cessation outcomes, and increased attention errors. ^[3]
• This provides only limited support for GABA‑modulating agents in nicotine addiction. ^[3]

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Safety Considerations of Gabapentin

Gabapentin is generally used for seizures and certain types of nerve pain, not for smoking cessation, and has known side effects:

• Common adverse effects: Dizziness and drowsiness (somnolence) are frequent. ^{[4] [5]}
• In neuropathic pain trials, people taking gabapentin often experienced at least one adverse event, with dizziness (~21%) and somnolence (~16%) commonly reported; withdrawals due to adverse events occurred in about 12%. ^[5]
• Dependence and withdrawal: There are rare reports of withdrawal symptoms (agitation, disorientation, confusion) after abruptly stopping high, non‑approved uses of gabapentin; symptoms resolved after restarting. ^{[6] [7]}
• Clinicians are advised to evaluate for misuse or abuse and monitor for drug‑seeking behavior. ^{[7] [8]}

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How Gabapentin Compares to Proven Smoking‑Cessation Options

Evidence‑supported first‑line treatments (not detailed in the trial above but widely recommended in clinical practice guidelines) typically include:

• Nicotine replacement therapy (patch, gum, lozenge, inhaler, nasal spray)
• Varenicline
• Bupropion SR
• Behavioral counseling and support

These options have consistently demonstrated improvements in quit rates and craving reduction, whereas gabapentin has not shown benefit over placebo for quitting in controlled trials. ^{[1] [2]}

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Practical Guidance

• Not recommended for quitting: Given the lack of demonstrated efficacy and the risk of side effects, gabapentin is generally not recommended for smoking cessation. ^{[1] [2]}
• If already taking gabapentin: Do not abruptly stop; discuss tapering with your clinician to avoid withdrawal‑like symptoms. ^{[6] [7]}
• Consider established therapies: Combining behavioral support with approved cessation medications offers the best chance of success.

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Summary Table: Gabapentin and Smoking Cessation

Aspect	Findings
Study design	Randomized, placebo‑controlled, adults seeking cessation; gabapentin 600 mg TID or 900 mg TID vs placebo; 9 weeks treatment + 1 week taper; 12 weeks follow‑up. [1]
Abstinence (quit rates)	Lower with gabapentin than placebo; difference not significant. [1] [2]
Smoking reduction	Reduction seen in all arms; no difference between gabapentin and placebo. [1] [2]
Safety	Common: dizziness, somnolence; notable adverse event rates in broader gabapentin trials. [4] [5]
Withdrawal concerns	Rare reports after abrupt discontinuation of high, non‑approved use; symptoms resolved upon restarting. [6] [7]
Overall conclusion	Gabapentin shows little promise for smoking cessation and is not recommended for this purpose. [1] [2]

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Bottom Line

Based on clinical trial evidence, gabapentin does not improve quit rates or reduce smoking more than placebo and is unlikely to help people quit smoking. Safer and more effective, evidence‑based treatments should be used instead. ^{[1] [2]}