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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Cynthia on April 11, 2000, at 12:06:39
I have recently been switched from Tegretol and Topamax to Carbatrol and Gabitril . Does anyone have experience with these meds?
Posted by Scott L. Schofield on April 13, 2000, at 14:53:29
In reply to Is anyone taking Carbatrol and Gabitril?, posted by Cynthia on April 11, 2000, at 12:06:39
> I have recently been switched from Tegretol and Topamax to Carbatrol and Gabitril . Does anyone have experience with these meds?
I know that the generic name for Tegretol is carbemazepine, and that of Topomax is topiramate. Do you know the generic names of Carbatrol and Gabitril?Thanks.
- Scott
Posted by Cynthia on April 14, 2000, at 9:23:36
In reply to Re: Is anyone taking Carbatrol and Gabitril?, posted by Scott L. Schofield on April 13, 2000, at 14:53:29
Scott- The carbetrol is an extended release capsule of the carbamazepine and the Gabitril is Tiagabine Hydrochloride. Any Information you may have would be helpful, Thanks!-Cynthia
> I know that the generic name for Tegretol is carbemazepine, and that of Topomax is topiramate. Do you know the generic names of Carbatrol and Gabitril?
>
> Thanks.
>
>
> - Scott
Posted by Scott L. Schofield on April 19, 2000, at 10:10:07
In reply to Re: Is anyone taking Carbatrol and Gabitril?, posted by Cynthia on April 14, 2000, at 9:23:36
> Scott- The carbetrol is an extended release capsule of the carbamazepine and the Gabitril is Tiagabine Hydrochloride. Any Information you may have would be helpful, Thanks!-Cynthia
> > I know that the generic name for Tegretol is carbemazepine, and that of Topomax is topiramate. Do you know the generic names of Carbatrol and Gabitril?Sorry I took so long.
What exactly did you want to know? What is it to be used for?
As far as Gabitril (tiagabine) is concerned, the net effect of its actions seems to be to produce an increase in the GABAergic neurotransmission that is thought to inhibit or calm other neurons from getting too excited. This is a property shared by most of the other anti-epileptic drugs (AEDs). The mechanism that may play the most important role in this is the ability of Gabitril to inhibit the reuptake of the neurotransmitter GABA. This is similar to the property of many antidepressants to inhibit the reuptake of the monoamine neurotransmitters (dopamine, norepinephrine, and serotonin), which is thought to be responsible, in part, for their therapeutic effect.
Gabitril is used as an add-on to other anticonvulsants in the treatment of certain types of epilepsy, as is Lamictal, Gabapentin, and Topomax. I guess it is hoped that like these other three drugs, Gabitril will provide some therapeutic benefit in treating bipolar disorder. Cruising Medline, I only found two studies testing Gabitril for treating mania. They provide conflicting results.
The side effect profile does not seem to be as appealing as the others.
- Scott-----------------------------------------------------------
3 : J Clin Psychiatry 1999 Nov;60(11):759-62 Related Articles, Books, LinkOut
Tiagabine appears not to be efficacious in the treatment of acute mania.Grunze H, Erfurth A, Marcuse A, Amann B, Normann C, Walden J
Department of Psychiatry, University of Munich, Germany. grunze@psy.med.uni-muenchen.de
BACKGROUND: Because a GABAergic hypofunction has been implied in the pathophysiology of mania, we have tested the antimanic properties of the GABA transporter 1 inhibitor tiagabine. METHOD: An open trial was conducted in 8 acutely manic inpatients with DSM-IV bipolar I disorder, 2 of them with tiagabine monotherapy and 6 with tiagabine as an add-on to previously insufficient mood-stabilizing medication. The study duration was 14 days. Changes in psychopathology were assessed by the Bech-Rafaelsen Mania Rating Scale. RESULTS: None of the patients showed clear-cut relief from manic symptoms during the 2-week observation period. In 2 patients, we saw pronounced side effects (nausea and vomiting in one and a generalized tonic-clonic seizure in the other). CONCLUSION: The results from this open trial suggest that tiagabine seems to have no pronounced antimanic efficacy compared with standard treatments such as valproate, lithium, or neuroleptics. It also appears that rapid dosage increases for antimanic treatment can cause potentially severe side effects.
Publication Types:
Clinical trialPMID: 10584764, UI: 20049459
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4 : Ann Clin Psychiatry 1998 Dec;10(4):181-4 Related Articles, Books, LinkOut
Adjunctive tiagabine treatment of psychiatric disorders: three cases.Kaufman KR
Department of Psychiatry, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08901, USA.
Anticonvulsants which effectively treat complex partial seizures are noted to have mood stabilizing effects (carbamazepine, valproate, lamotrigine, gabapentin). Tiagabine, a novel GABA uptake inhibitor anticonvulsant with similar indications, was used as adjunctive therapy to control psychiatric symptoms in three patients--two with bipolar disorder and one with schizoaffective disorder, bipolar type. All three patients improved during adjunctive low dosage tiagabine treatment and no untoward side effects were noted. Clinicians are advised to consider this new anticonvulsant as a potential adjunctive agent in the treatment of bipolar and schizoaffective disorders. Controlled trials are indicated.
PMID: 9988060, UI: 99140559
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16 : Clin Neuropharmacol 1999 Nov-Dec;22(6):312-7 Related Articles, Books, LinkOut
A review of the antiepileptic drug tiagabine.Schachter SC
Office of Clinical Trials and Research, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Tiagabine (TGB), a recently approved antiepileptic drug (AED), has a specific mechanism of action that is unique among AEDs. A potent AED with linear, predictable pharmacokineties, it inhibits gamma-aminobutyric acid (GABA) reuptake into neurons and glia. Tiagabine does not have any clinically relevant effects on hepatic metabolism or on serum concentrations of other AEDs, nor does it interact with commonly used non-AEDs. The most common side effects of TGB in controlled studies are dizziness, asthenia, somnolence, accidental injury, infection, headache, nausea, and nervousness. These events are usually mild to moderate in severity and generally do not require medical intervention. At dosages of 30-56 mg daily, TGB is an effective add-on treatment for partial seizures. Although patients who have medically refractory epilepsy can be converted to TGB monotherapy, more controlled studies are necessary to confirm the efficacy of TGB as monotherapy and to determine the effective dosage range.
Publication Types:
Review
Review, tutorialPMID: 10626090, UI: 20091535
Posted by Cynthia M. on April 19, 2000, at 16:16:14
In reply to Re: Is anyone taking Carbatrol and Gabitril?, posted by Scott L. Schofield on April 19, 2000, at 10:10:07
Scott- Thanks so much for the info regarding Gabitril. I appreciate the effort. I am on a low dose right now and don't feel the need to increase it. I have been having some nausea and now I see were it is coming from. I am having good success so far with this combination along with 300 mg seroquel at night and 15 mg remeron also at night. I am feeling more stable than I have in months and have not had one episode of rapid cycling in a week ( a record for me lately) I have noticed some edema and will use lasix prn, I am hoping it will subside as I had this problem while on the neurontin. It is worth it to me to be controlled no matter the weight gain and swelling. Thanks so much for the info-Cynthia M.
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