Abstract: Antiepileptic tiagabine promising for anxiety with depression
posted Thursday, 2 March 2006
J Clin Psychiatry. 2006 Jan;67(1):66-71.
Open-label tiagabine monotherapy for major depressive disorder with anxiety.
Carpenter LL, Schecter JM, Tyrka AR, Mello AF, Mello MF, Haggarty R, Price LH.
From the Mood Disorders Research Program, Butler Hospital and the Department of Psychiatry and Human Behavior, Brown Medical School, Providence, R.I.
OBJECTIVE: Gamma-aminobutyric acid (GABA) plays a key role in the pathophysiology and treatment of depression and anxiety. Tiagabine, a selective GABA reuptake inhibitor (SGRI) that enhances normal GABA tone, was evaluated for its efficacy and safety in the treatment of depression comorbid with significant anxiety.
METHOD: In this 8-week, single-center, open-label study, adults with DSM-IV-diagnosed major depressive disorder and significant anxiety (i.e., "anxious depression") received tiagabine monotherapy, initiated at 4 mg/day and titrated for optimum response as tolerated to a maximum dose of 20 mg/day. Symptoms, function, and adverse events were assessed at regular intervals. Patients were entered from April 2002 to February 2003.
RESULTS: Nineteen patients entered the study and 15 met criteria for intent-to-treat analyses. Of those, 6 (40%) discontinued treatment and 9 (60%) completed the 8-week protocol. Tiagabine significantly improved depression, as shown by a reduction in mean +/- SD Hamilton Rating Scale for Depression scores from baseline (31.9 +/- 6.1) to endpoint (17.0 +/- 12.4; p = .002). Categorical response rate was 47% (N = 7). Tiagabine also significantly improved anxiety (Hamilton Rating Scale for Anxiety baseline score of 22.7 +/- 4.9 vs. endpoint score of 12.5 +/- 8.8; p = .002). The mean +/- SD final daily dose was 12.8 +/- 5.8 mg. The most commonly reported adverse events were dizziness, headache, and gastrointestinal upset/nausea.
CONCLUSION: These results suggest the potential of the SGRI tiagabine in the treatment of depression with anxiety. Large, placebo-controlled trials are needed.
PMID: 16426090 [PubMed - in process]
(Text has been reformatted for clarity; Ed.)
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