An open-label study to evaluate switching from an SSRI or SNRI to tiagabine to alleviate antidepressant-induced sexual dysfunction in generalized anxiety disorder.
BACKGROUND
This study investigated tiagabine monotherapy in subjects with generalized anxiety disorder (GAD) who had been switched from selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) as a result of antidepressant-induced sexual dysfunction.


METHODS
Adults with DSM-IV GAD, an adequate therapeutic response (> or =50% decrease in Hamilton Rating Scale for Anxiety [HAM-A] total score) to SSRI or SNRI and sexual dysfunction were switched to open-label tiagabine 4-12 mg/day for 14 weeks. Assessments included the HAM-A, Hospital Anxiety & Depression Scale (HADS) and the Arizona Sexual Experiences Scale (ASEX); assessments were made at baseline and at Weeks 4, 8, and 14.


RESULTS
Twenty six subjects were included in the analysis. Tiagabine showed no worsening in baseline symptoms of GAD, with non-significant changes from baseline in mean HAM-A total scores and HADS Anxiety and Depression subscale scores. There was a significant (p < 0.001) reduction in ASEX total scores from baseline following tiagabine, indicating an alleviation of sexual dysfunction. Tiagabine was reasonably tolerated; the most commonly reported adverse events were dizziness/light headedness (n = 6; 23%), nausea (n = 6; 23%) and fatigue (n = 2; 8%).


CONCLUSIONS
Tiagabine may be useful in subjects who respond to previous antidepressant therapy but develop sexual dysfunction as an adverse event.
Schwartz
Thomas L
TL
Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY 13210, USA. schwartzresearch1@yahoo.com
Nasra
George S
GS
Ashton
Adam K
AK
Kang
David
D
Kumaresan
Hari
H
Chilton
Mark
M
Bertone
Francesca
F
D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D018755:GABA Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009557:Nipecotic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000517:prevention & control; D000078308:Tiagabine
D018759:Adrenergic Uptake Inhibitors; D000927:Anticonvulsants; D018687:Antidepressive Agents, Second-Generation; D018755:GABA Agonists; D009557:Nipecotic Acids; D017367:Selective Serotonin Reuptake Inhibitors; D000078308:Tiagabine