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Tiagabine May Be Useful Augmentation Therapy in Patients with Generalised Anxiety Disorder: Presented at ADAA

By Jerry Ingram

MIAMI, FL -- March 16, 2004 -- Tiagabine might be effective as augmentation therapy for patients on selective serotonin-reuptake inhibitors for generalised anxiety disorder (GAD), according to a preliminary study presented here on March 13^th at the annual conference of the Anxiety Disorders Association of America.

"Since we know that 40% of patients do not respond with only SSRIs, we added tiagabine to see how it worked over an 8-week period. We saw that 50% of the patients became responders and 40% of the patients actually had remission," said Nikhil Nihalani, MD, Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, United States.

For this open-label study, Nihalani and his colleagues enrolled 25 patients with GAD who were taking SSRI medications but were not responding to treatment. The researchers began the participants on tiagabine 4 mg/daily and titrated them upwards by 4 mg weekly to a maximum dose of 16mg/day (8 mg/twice daily).

Researchers utilised the Hamilton Rating Scale for Anxiety (HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Sheehan Disability Scale (SDS) to determine the efficacy of treatment with tiagabine.

Tiagabine -- a selective gamma-aminobutyric acid (GABA)-reuptake inhibitor (SGRI) -- improved anxiety (HAM-A±SD baseline, 20.9±3.7; last observation, 11.7±8.1; P < .001), with 40% of patients achieving remission, the researchers said. In addition, they noted that tiagabine also improved sleep quality (PSQI: baseline, 10.0±3.7; last observation, 7.6±4.2; P < .001) and patients' overall functioning/disability (SDS: baseline, 15.2±5.2; last observation, 10.5±6.7; P = .001).

The study's authors suggest that the SGRI tiagabine may be a useful tool as augmentation therapy for patients suffering with GAD who are partial responders to SSRI monotherapy. They note, however, that larger, controlled studies are needed to determine optimal dosing for tiagabine.


[Study Title: Augmentation Therapy to SSRIs In Patients With Generalized Anxiety Disorder. Abstract 72]

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