Gabapentin and Tiagabine: Effective drugs in Bipolar Disorders?
Authors: Mauro Giovanni Carta, Maria Julieta Hardoy, Bernardo Carpiniello, Maria Carolina Hardoy
Affiliation: Division of Psychiatry, Department of Public Health, University of Cagliari, Italy
Correspondence and requests for reprints should be addressed to:
Mauro Giovanni Carta
Division of Psychiatry, Department of Public Health
University of Cagliari
Via Liguria 13, 09127 Cagliari, Italy
Tel. +39 070 42760/+39 070 272748/+39 335 499994
Fax +39 070 496295
E-mail: mgcarta@tiscali.it
Abstract
Objectives:
A review on the clinical uses of anticonvulsants Gabapentin (GBP) and Tiagabine (TGB) in affective disorders has been carried out.
Methods:
Computer searches of the biomedical literature and abstract books from the more important scientific psychiatric congresses were undertaken to identify all pertinent case reports, case series and studies of GBP and TGB in mood disorders through December 2002.
Results:
Open-label studies and two published, controlled trials suggest that GBP may have a role in the treatment of patients with bipolar disorders. However, in two further double-blind studies, GBP has not been found to be efficacious in the treatment of refractory mania or refractory bipolar depression. The two studies carried out to evaluate TGB efficacy at 2 weeks found an improvement in 7.2% of manic patients, and in 42.9% of depressed subjects. The rapid dosage increases required for antimanic treatment, may cause potentially severe side effects.
Conclusions:
On the basis of the studies available, GBP may have a role in bipolar disorders only as adjunctive treatment for the treatment of depression, anxiety and impulsiveness. Thus, it may be a valuable tool particularly in patients with comorbid psychiatric disorders, or complex clinical situations, which would benefit from the use of a safe, easily manageable drug. Future studies should be carried out using appropriate methods and instruments capable of measuring specific components that may benefit from the use of GBP. Data available do not appear to support the use of TGB in acute mania; the drug does not represent a valid option due to the need for slow, progressive titration.
Key Words: Gabapentin, Tiagabine, anticonvulsants, antiepileptics, bipolar disorder,
mood disorders, affective disorders, mood stabilizers.
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