Antiepileptics tiagabine

GABA transporter GAT1 (SLC6A1) GABAergic neurons in CNS <10 Clearance of interstitial neurotransmitter, reuptake into neurons Tiagabine, an antiepileptic drug... 

Angehagen M, Ben-Menachem E, Ronnback L, Hans-son E. Novel mechanisms of action of three antiepileptic drugs, vigabatrin, tiagabine, and topiramate. Neurochem Res. 2003 28 333-340. 

Current research is also exploring the possible benefit of certain antiepileptic medications (pregabalin and tiagabine) for the treatment of GAD, but conclusive results are still pending. CBT, alone or in combination with medications, is effective for GAD as well, and its benefits tend to extend beyond the completion of formal treatment and exceed the protective effect conferred by medication. 

BARBITURATES 1. CARBAMAZEPINE 2. LAMOTRIGINE 3. TIAGABINE 4. VALPROATE 5. ZONISAMIDE L levels of these antiepileptics Induction of metabolism Watch for poor response to these antiepileptics... 

Clearance of tiagabine may be reduced and thus plasma levels increased if taken with a non-enzyme inducing antiepileptic drug (e.g., valproate, gabapentin, lamotrigine), so tiagabine dose may need to be reduced... 

Clearance of tiagabine is increased if taken with an enzyme-inducing antiepileptic drug (e.g., carbamazepine, phenobarbital, phenytoin, primidone) and thus plasma levels are reduced however, no dose adjustments are necessary for treatment ot epilepsy as the dosing recommendations for epilepsy are based on adjunctive treatment with an enzyme-inducing antiepileptic drug... 

The rationale and use of modified-release formulations of antiepileptic drugs (carbamazepine, valproic acid, and tiagabine) have been reviewed (171). The authors concluded that modified-release formulations afford the advantages of better patient compliance, fewer adverse effects, and less fluctuation in plasma concentrations, making monitoring of drug concentrations easier. They concluded that these advantages should lead to better seizure control and improved quahty of life. 

Snel S, Jansen JA, Pedersen PC, Jonkman JH, van Heiningen PN. Tiagabine, a novel antiepileptic agent lack of pharmacokinetic interaction with digoxin. Fur J Qin Pharmacol 1998 54(4) 355-7. 

The effect of tiagabine on visual function has been stndied in 15 patients with chronic partial epilepsy treated for 23-55 months with tiagabine monotherapy after fail-nre with standard antiepileptic drug monotherapy (23). Three patients had localized field losses (two qnadranta-nopic and one hemianopic) from earlier brain lesions. Tiagabine had no effect on visual fields but acquired color vision defects were found in seven of 14 patients contrast sensitivity was unaffected. 

Perucca E, Bialer M. The clinical pharmacokinetics of the newer antiepileptic drugs. Focus on topiramate, zonisamide and tiagabine. Clin Pharmacokinet 1996 31(1) 29 6. 

Other antiepileptic drugs can also alter visual evoked potentials and brainstem evoked potentials. Visual field defects associated with various antiepileptic drugs (carba-mazepine, diazepam, gabapentin, phenytoin, tiagabine, and vigabatrin) have been reviewed (37). 

Tiagabine is used as adjunct therapy in the control refractive partial seizures. When added to other antiepileptic drug regimens, tiagabine significantly decreases seizure frequency (by 50 percent or more) in about 25 percent of patients with refractory complex partial seizures and in roughly 32 percent of patients with simple complex seizures. 

Moderate social drinking does not appear to affect the serum levels of carbamazepine, ethosuximide or phenytoin. Some small changes are seen in the serum levels of phenobarbital and sodium valproate, but no changes in the control of epilepsy seem to occur. No pharmacokinetic interaction was detected between tiagabine and alcohol, and tiagabine did not alter the cognitive effect of alcohol. The adverse effects of both alcohol and antiepileptics, such as enhanced sedation, may be additive. 

Tiagabine piasma ieveis are reduced by enzyme-inducing antiepileptics (carbamazepine, phenytoin, phenobarbital and primi-... 

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