Transient dystonias in three patients treated with tiagabine.
OBJECTIVE
Tiagabine (TGB) is a new antiepileptic drug (AED) with gamma-aminobutyric acid (GABA)ergic mechanism of action. GABAergic compounds may influence the extrapyramidal system, probably via modulation of dopaminergic nigrostriatal neurons. A well-known side effect of TGB is probably dose-related extrapyramidal tremor. To our knowledge, acute dystonias associated with TGB treatment have yet to be described.


METHODS
Three patients with transient acute dystonic reactions while taking TGB as add-on therapy with carbamazepine (CBZ) are presented. The focal limb dystonia in one case, an oromandibular dystonia in second, and writer's cramp in third one were observed.


RESULTS
In all cases dystonic movements resolved spontaneously without discontinuation of TGB therapy and without any concomitant treatment.


CONCLUSIONS
Tiagabine may cause various mild extrapyramidal side effects. All three cases reported were diagnosed with transient possibly drug-related dystonia after increase in TGB dose. It remain unclear whether dystonic movements are specific for patients treated with TGB/CBZ bitherapy.
Wolańczyk
T
T
Department of Child Psychiatry, Medical University of Warsaw, Poland. twolancz@amwaw.edu.pl
Grabowska-Grzyb
A
A
D000208:Acute Disease; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001480:Basal Ganglia Diseases / Q000139:chemically induced; D002220:Carbamazepine / Q000627:therapeutic use; D002648:Child; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004421:Dystonia / Q000139:chemically induced* / Q000175:diagnosis; D004827:Epilepsy / Q000188:drug therapy*; D017034:Epilepsy, Frontal Lobe / Q000188:drug therapy; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D009557:Nipecotic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D000078308:Tiagabine
D000927:Anticonvulsants; D009557:Nipecotic Acids; D002220:Carbamazepine; D000078308:Tiagabine