Low-dose tiagabine effectiveness in anxiety disorders

Gamma-aminobutyric acid (GABA), the predominant inhibitory neurotransmitter of the central nervous system, is involved in the pathophysiology of a wide variety of disorders, including anxiety. Tiagabine hydrochloride acts as a selective GABA reuptake inhibitor (SGRI).

Consecutive patients were offered tiagabine in 1-mg incremental doses for the treatment of anxiety, primarily generalized anxiety disorder. Individuals failing anxiety treatment with benzodiazepines, selective serotonin reuptake inhibitors, and buspirone, and/or with a strong family or personal history of substance abuse were allowed trials. The SGRI tiagabine improved anxiety and was well tolerated by adult patients with generalized anxiety disorder as well as one patient with anxiety secondary to acute antidepressant withdrawal. One disinhibition treatment failure is also discussed.

In acute anxiety treatment, very low initial dosing with gradual increases may be sufficient for anxiety effects, when compared with the higher doses of tiagabine used in epilepsy treatment. Tiagabine may be useful in the treatment of generalized anxiety disorder.