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Tiagabine and non-convulsive status epilepticus
1Department of Neurological Science, Walton Centre for Neurology and Neurosurgery, Liverpool, UK.
Seizure
|June 1, 1996
Summary
High doses of the investigational antiepileptic drug tiagabine may paradoxically worsen seizures. Non-convulsive status epilepticus occurred in three patients, resolving after tiagabine dose reduction or discontinuation.
Area of Science:
- Neuroscience
- Clinical Pharmacology
- Epileptology
Background:
- Tiagabine is an investigational antiepileptic drug (AED) that enhances gamma-aminobutyric acid (GABA)ergic neurotransmission.
- GABAergic drugs are generally considered to have anticonvulsant properties.
- Paradoxical effects of medications can occur, leading to unexpected clinical outcomes.
Observation:
- Three patients developed non-convulsive status epilepticus (NCSE) while receiving high doses of tiagabine.
- This occurred at doses of 48-60 mg/day, often in combination with other AEDs.
Findings:
- Seizure control improved in patients after their tiagabine dosage was reduced or the drug was discontinued.
- This suggests a direct, paradoxical epileptogenic effect of tiagabine.
Implications:
- Clinicians should be aware of the potential for tiagabine to induce seizures at high doses.
- This highlights a possible paradoxical epileptogenic effect of GABA-ergic drugs.