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Transient dystonias in three patients treated with tiagabine
T Wolańczyk1, A Grabowska-Grzyb
1Department of Child Psychiatry, Medical University of Warsaw, Poland. twolancz@amwaw.edu.pl
Purpose:
Tiagabine (TGB) is a new antiepileptic drug (AED) with gamma-aminobutyric acid (GABA)ergic mechanism of action. GABAergic compounds may influence the extrapyramidal system, probably via modulation of dopaminergic nigrostriatal neurons. A well-known side effect of TGB is probably dose-related extrapyramidal tremor. To our knowledge, acute dystonias associated with TGB treatment have yet to be described.
Methods:
Three patients with transient acute dystonic reactions while taking TGB as add-on therapy with carbamazepine (CBZ) are presented. The focal limb dystonia in one case, an oromandibular dystonia in second, and writer's cramp in third one were observed.
Results:
In all cases dystonic movements resolved spontaneously without discontinuation of TGB therapy and without any concomitant treatment.
Conclusions:
Tiagabine may cause various mild extrapyramidal side effects. All three cases reported were diagnosed with transient possibly drug-related dystonia after increase in TGB dose. It remain unclear whether dystonic movements are specific for patients treated with TGB/CBZ bitherapy.