New adjunctive therapy option
Tiagabine HCl (Gabitril, Abbott) is the fifth drug to be marketed for treatment of partial seizures in the last 5 years. It's indicated as adjunctive therapy in adults and children 12 years and older. Tiagabine is thought to exert its antiseizure effect by increasing activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter.
As with other antiseizure drugs, CNS reactions are the most common adverse reactions. Potential problems include dizziness or light-headedness, asthenia, somnolence, nervousness or irritability, tremor, and difficulty with concentration or attention. Advise your patient not to engage in activities such as driving or operating machinery until she determines how the medication affects her. Also inform her that taking the medication concurrently with other drugs with CNS depressant activity can increase adverse reactions and suggest that she avoid alcoholic beverages. Other common adverse reactions, include nausea, vomiting, diarrhea, abdominal pain, and rash, including infrequent reports of serious rashes.
About 1% of patients in clinical studies experienced moderately severe to incapacitating generalized weakness, which resolved when the dosage was reduced or the drug discontinued.
Teach the patient to take tiagabine with food in divided doses two to four times daily. Warn her not to stop the drug without her physician's supervision. To prevent increased seizure activity, the dosage should be tapered gradually.
Tiagabine should be used during pregnancy only if clearly needed.
Tiagabine isn't available in Canada.
Copyright Springhouse Corporation Jul 1998
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