Tiagabine (TGB), approved as adjunctive therapy for partial seizures, is a generally well-tolerated AED. Its central nervous system side effects resemble those of most other AEDs, including dizziness, headache, ataxia, and nervousness.97

One study of its use in treating patients with intractable epilepsy demonstrated mood improvements among patients converted to TGB monotherapy. Mood elevation was not correlated with seizure reduction, suggesting that positive psychotropic benefits may be independent of antiepileptic effects.98 Other series have noted TGB-related emotional lability and depression.100

Limited case series also note potential benefits against bipolar disorder.99

A rare cause of personality changes and behavioral abnormalities in patients receiving TGB for partial seizures is TGB-induced absence status epilepticus.101

The literature regarding the use of TGB in people with developmental disabilities (DD) is sparse, perhaps because of its limited utility in generalized seizure disorders. Some have suggested that significant numbers of patients left TGB drug trials as a result of developing depressive symptoms.102 However, Dodrill et al.103 demonstrated improved mood and psychosocial adjustment when patients were switched from other AEDs to TGB monotherapy.98 Studies of TGB in DD populations have shown no obvious deleterious cognitive side effects.103,104

Adapted from: Ettinger AB, Barr WB, and Solomon SP. Psychotropic properties of antiepileptic drugs in patients with developmental disabilities. In: Devinsky O and Westbrook LE, eds. Epilepsy and Developmental Disabilities. Boston: Butterworth-Heinemann; 2001;219–230. With permission from Elsevier (www.elsevier.com).

Authored By: 
Sanford P. Solomon MD
William B. Barr MD
Alan B. Ettinger MD
Reviewed By: 
Steven C. Schachter MD
Thursday, April 1, 2004