Tiagabine for Posttraumatic Stress Disorder: A Case Series of 7 Women
J Clin Psychiatry 2003;64(12):1421-1425
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Posttraumatic stress disorder
(PTSD) is often a chronic disorder, and, though 2 antidepressants
are now approved by the U.S. Food and Drug Administration for its
treatment, it often remains refractory to pharmacotherapy. The
memory of traumatic events, by repeatedly stimulating the
hippocampus and amygdala (kindling phenomenon), may alter
multiple biological systems, including gamma-aminobutyric acid
(GABA) pathways, and eventually lead to the disorder. Tiagabine,
a selective GABA reuptake inhibitor, was evaluated as a treatment
Method: Patients with DSM-IV PTSD who
were stable on current medications and still symptomatic were
eligible for inclusion in this open-label case series. Tiagabine
was initiated at 2 mg nightly and increased by 2-mg increments
every 2 to 3 days until an optimal response was achieved. The
Clinical Global Impressions-Improvement scale and PTSD
Checklist-Civilian Version (PCL-C) were used to evaluate changes
in PTSD symptoms.
Results: Seven consecutive female
patients were identified as eligible. Tiagabine markedly improved
PTSD symptoms within 2 weeks for 6 of the 7 patients, and 6
patients were rated as "much improved" or "very
much improved." The mean PCL-C score was significantly
reduced at weeks 2 and 8 (p < .05) as were the 3 PCL-C
subscales and 1 of 2 items related to sleep disturbance. The mean
effective daily dosage was approximately 8 mg (range, 4-12
mg/day). Treatment with tiagabine was generally well tolerated.
Conclusions: These preliminary open-label
findings suggest that the selective GABA reuptake inhibitor
tiagabine may be a promising therapeutic option in the treatment
of PTSD. Further study into the efficacy and safety of tiagabine
for the treatment of PTSD is warranted.