Does anyone take Gabitril?

Discussion in 'Fibromyalgia Main Forum' started by Dawnt, Sep 11, 2002.

  1. Dawnt

    Dawnt Member

    I've searched the net about Gabitril, and it seems to be somewhat like Neurontin. I had taken Neurontin after an accident with my arm a few years ago and after a day had to stop. With my mind not working anymore I don't remember why. I've recently become allergic to have alot of medicines and am "afraid" to take new ones, especially new one's on the market. I would like to know if this works for anyone and if they have any side effects.

    thank you
    Dawn
  2. Dawnt

    Dawnt Member

    I've searched the net about Gabitril, and it seems to be somewhat like Neurontin. I had taken Neurontin after an accident with my arm a few years ago and after a day had to stop. With my mind not working anymore I don't remember why. I've recently become allergic to have alot of medicines and am "afraid" to take new ones, especially new one's on the market. I would like to know if this works for anyone and if they have any side effects.

    thank you
    Dawn
  3. Shirl

    Shirl New Member

    This is all that I could find on Gabitril, its long, but maybe you could find what you want to know about it here.

    Hopefully someone on the board has first hand experience with it.

    I got this from; www.medscape.com

    There is additional information there if you are interested in reading all of it.

    Shalom, Shirl



    ____________________________________________________________

    GABITRIL ORAL

    Uses & Dosage
    Uses from First Databank





    Labeled Uses


    Complex-Partial Epilepsy
    Simple-Partial Epilepsy

    Unlabeled Uses



    Uses from AHFS DI™

    Partial Seizures
    Tiagabine hydrochloride is used in combination with other anticonvulsant agents in the management of partial seizures. In controlled clinical studies, adjunctive therapy with tiagabine was effective in reducing seizure frequency in patients with simple and/or complex partial seizures refractory to therapy with one or more conventional anticonvulsant drugs (e.g., carbamazepine, phenytoin, valproate).In 2 multicenter, parallel-group studies conducted in the US, patients received tiagabine or placebo in addition to their existing anticonvulsant regimen, and efficacy of the drug was evaluated principally in terms of the median decrease (from baseline) in the frequency of complex partial seizures per 4-week period during adjunctive treatment;the median frequency of all partial seizures per 4-week period also was recorded in these studies.In the first US study, patients were randomized to receive adjunctive therapy with placebo or 16, 32, or 56 mg of tiagabine hydrochloride administered in 4 divided doses daily for 12 weeks (after a 4-week titration period to achieve the assigned daily dosage).In patients receiving adjunctive tiagabine therapy, a reduction from baseline of 2.2 or 2.9 in the median 4-week frequency of complex partial seizures occurred with tiagabine hydrochloride dosages of 32 or 56 mg daily, respectively, while the median reduction in the 4- week frequency of all partial seizures in patients receiving adjunctive tiagabine was 2.7 or 3.5, respectively.Seizure frequency did not decrease substantially in patients receiving adjunctive therapy with placebo or tiagabine hydrochloride 16 mg daily.To determine the potential for tiagabine to induce withdrawal seizures, the dosage of tiagabine hydrochloride was gradually reduced and the drug discontinued over a 4-week period in this study.An increased frequency of seizures was noted for each type of partial seizure, for all types of partial seizures combined, and for secondarily generalized tonic-clonic seizures in patients receiving tiagabine; the increase in seizure frequency was similar regardless of tiagabine hydrochloride dosage.In a second US study, patients were randomized to receive tiagabine hydrochloride 16 mg twice daily, 8 mg 4 times daily, or placebo for 8 weeks as an adjunct to existing anticonvulsant therapy after a 4-week dosage titration period.Patients receiving tiagabine hydrochloride 8 mg 4 times daily experienced a median reduction of 1.3 in the 4-week frequencies of both complex partial and all partial seizures, although the difference in seizure frequency reduction for all partial seizures was not statistically significant.Patients receiving tiagabine hydrochloride 16 mg twice daily or placebo did not experience a substantial reduction in 4-week seizure frequency for either complex partialor all partial seizures.In a multicenter, parallel-group study conducted in Europe, patients were randomized to receive adjunctive therapy with 10 mg of tiagabine hydrochloride or placebo 3 times daily for 12 weeks after a 6-week dosage titration period.Efficacy of tiagabine was evaluated principally in terms of the proportion of patients achieving at least a 50% reduction from baseline (i.e., on existing anticonvulsant therapy) in the 4-week frequency of all partial seizures during treatment with tiagabine or placebo; however, the difference in the median decrease of seizure frequency between patients receiving tiagabine or placebo was insubstantial.Secondary analyses were performed using evaluation criteria similar to those used in the US studies (i.e., median decrease from baseline in the 4-week frequency of complex partial or all partial seizures).In these analyses, patients receiving tiagabine experienced a substantial median decrease from baseline of 1.3 or 1.1 in the 4- week frequency of complex partial or all partial seizures, respectively,but patients receiving placebo tended to have a median increase in the 4- week frequency of complex partial or all partial seizures.In 2 other small, placebo-controlled crossover studies, which consisted of a dosage titration period of at least 4 weeks followed by two 7-week treatment periods with a 3-week washout period between treatments (tiagabine followed by placebo, or placebo followed by tiagabine), median within-patient reductions in the frequency of complex partial and all partial seizures per 4-week period during administration of tiagabine were greater than those reported during placebo administration.Dosage and Administration from AHFS DI™

    Administration
    Tiagabine hydrochloride is administered orally. Food delays but does not decrease the extent of tiagabine absorption. The manufacturer states that tiagabine should be taken with food.
    Dosage
    Safety and efficacy of tiagabine in children younger than 12 years of age have not been established.In addition, the manufacturer states that clinical trials have not included sufficient numbers of patients older than 65 years of age to determine whether they respond differently than do younger patients, and safety and efficacy of tiagabine in geriatric patients have not been established.However, the pharmacokinetic profile of tiagabine in healthy geriatric adults was similar to that in healthy young adults in clinical trials.The manufacturer states that a therapeutic range of plasma tiagabine concentrations has not been established;however, because of the potential for altered tiagabine clearance during concurrent administration of hepatic microsomal enzyme-inducing or -inhibiting drugs, it may be useful to determine plasma tiagabine concentrations before and after changes are made to the patient’s drug regimen.Tiagabine undergoes extensive hepatic metabolism,and the plasma half-life of the drug is decreased from 7—9 hours to 4—7 hours in patients concomitantly receiving an anticonvulsant drug that induces hepatic microsomal enzymes (e.g., carbamazepine, phenobarbital, phenytoin, primidone).Because all clinical trials of tiagabine therapy were conducted in patients receiving at least one enzyme-inducing anticonvulsant drug, patients receiving only non-enzyme- inducing anticonvulsants (e.g., gabapentin, lamotrigine, valproic acid) should receive a reduced dosage of tiagabine hydrochloride or slower dosage titration.Patients receiving a combination of enzyme-inducing and non- enzyme-inducing anticonvulsant drugs (e.g., carbamazepine and valproate) should be considered to have induced hepatic microsomal enzymes.Tiagabine does not appear to induce or inhibit hepatic microsomal enzymesnor does it appear to have any clinically important interactions with other anticonvulsants.Therefore, unless clinically indicated, modification of concomitant anticonvulsant therapy is not necessary when tiagabine is added to an existing anticonvulsant regimen.Because of the possibility of increasing seizure frequency, anticonvulsant drugs, including tiagabine, should not be discontinued abruptly.The manufacturer states that withdrawal of tiagabine has been associated with increased seizure frequency and that the drug should be withdrawn gradually unless more rapid withdrawal is required for the safety of the patient.(See Uses.)Because tiagabine is highly (96%) protein bound, it may be displaced from plasma protein binding sites or may displace other protein-bound drugs from such binding sites.In vitro, valproic acid reduces tiagabine plasma protein binding from 96.3 to 94.8%, which results in a 40% increase in free plasma tiagabine concentrations;however, the clinical relevance of tiagabine displacement from plasma proteins by valproic acid has not been established.Dosages of tiagabine hydrochloride exceeding 4 mg daily should be administered as 2—4 divided doses daily.
    Adult Dosage
    For adjunctive therapy in the management of partial seizures in adults 18 years of age and older, the initial dosage of tiagabine hydrochloride is 4 mg once daily for the first week of therapy.Beginning with the second week of treatment, the total daily dosage of tiagabine hydrochloride (administered as 2—4 divided doses) may be increased by 4—8 mg at weekly intervals until a clinical response is achieved or a total daily dosage of 56 mg is reached.The usual maintenance dosage of tiagabine hydrochloride in adults is 32—56 mg daily. The manufacturer states that dosages exceeding 56 mg daily have not been evaluated systematically in controlled clinical studiesand that limited experience exists in adults receiving tiagabine hydrochloride twice daily at daily dosages exceeding 32 mg.
    Adolescent Dosage
    The usual initial dosage of tiagabine hydrochloride in adolescents 12—18 years of age is 4 mg once daily for the first week of therapy.Daily dosage may be increased to 4 mg twice daily beginning with the second week of treatment; thereafter, the total daily dosage (administered in 2—4 divided doses) may be increased by 4—8 mg at weekly intervals until a clinical response is achieved or a total daily dosage of 32 mg is reached. The manufacturer states that daily dosages exceeding 32 mg have been tolerated in a limited number of adolescents for a relatively short duration.
    Dosage in Renal and Hepatic Impairment
    The manufacturer states that the pharmacokinetics of total and unbound tiagabine are similar among patients with normal renal function (creatinine clearance greater than 80 mL/minute); those with mild, moderate, or severe renal impairment (creatinine clearance of 40—80, 20—39, or 5—19 mL/minute, respectively);and patients with renal failure undergoing hemodialysis.Tiagabine clearance is decreased in patients with hepatic impairment,and the manufacturer states that such patients may require decreased initial and maintenance dosages of tiagabine and/or longer dosing intervals than patients who have normal hepatic function.However, the manufacturer makes no specific recommendations for dosage adjustment in such patients.Description from AHFS DI™
    Tiagabine, a nipecotic acid derivative, is an anticonvulsant agent.The drug is commercially available as the hydrochloride salt and differs structurally from other currently available anticonvulsant agents.Although the precise mechanism of action of tiagabine is unknown, the drug enhances inhibitory neurotransmission mediated by Gamma- aminobutyric acid (GABA).Tiagabine increases the amount of GABA available in extracellular spaces of the globus pallidus, ventral pallidum, and substantia nigra,suggesting a GABA-mediated anticonvulsant mechanism of action (i.e., inhibition of neural impulse propagations that contribute to seizures).Tiagabine inhibits presynaptic neuronal and glial GABA reuptake,and increases the amount of GABA available for postsynaptic receptor binding.The drug does not stimulate GABA release, and does not have activity at other receptor binding and uptake sites at concentrations that inhibit the uptake of GABA.Tiagabine selectively blocks presynaptic GABA uptake by binding reversibly and saturably to recognition sites associated with GABA transporter protein in neuronal and glial membranes.Tiagabine exhibits anticonvulsant activity in several animal seizure models.Although the drug is effective against tonic seizures induced in some animals by subcutaneous administration of pentylenetetrazole (PTZ),tiagabine is only partially effective against PTZ-induced clonic seizures in some animals,indicating that it may not have substantial activity against absence seizures in humans.Tiagabine decreases seizure severity and aftercharge duration in animals with amygdala-kindled seizures,indicating potential anticonvulsant activity against partial seizures in humans.Tiagabine exhibits a dose-dependent effect against clonic seizures induced by proconvulsant methyl-6,7-dimethyoxy-4-ethyl-beta-carboline-3-carboxylate (DMCM), with diminished effectiveness at higher dosages,and is effective against audiogenic seizures in genetically epilepsy-prone animals.Tiagabine is partially effective against picrotoxin- induced seizures,icuculline-induced seizures,photic seizures,and is minimally effective against maximal electroshock seizures (MES) in animals.In vitro binding studies indicate that tiagabine does not inhibit substantially the uptake of dopamine, norepinephrine, serotonin, glutamate, or choline,and does not bind substantially to dopamine D1 or D2;cholinergic muscarinic;serotonergic type 1A, type 2, or type 3 (5HT1A, 5HT2, or 5HT3, respectively);alpha1- or alpha2-adrenergic; beta1- or beta2-adrenergic;histamine H2 or H3;denosine A1 or A2;opiate µ or Kappa1;glutamate N-methyl-d- aspartate (NMDA);or GABAA receptors.Also, tiagabine has little or no affinity for sodium or calcium channels.Tiagabine binds to histamine H1, serotonergic type 1B ( 5HT1B), benzodiazepine, and chloride channel receptors at concentrations 20—400 times those that inhibit the uptake of GABA.SumMon® (see Users Guide). For additional information on this drug until a more detailed monograph is developed and published, the manufacturer’s labeling should be consulted. It is essential that the labeling be consulted for detailed information on the usual cautions, precautions, and contraindications.



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  4. teach6

    teach6 New Member

    Before I was dx'd I saw a rheumy who I thought might be able to help me with my CFS/FMS, but he told me he didn't believe in CFS and if I had FMS there wasn't much he could do for me.

    Then he handed me a sample box of Gabitril and told me to try it. He gave me no instructions on taking it. When I was leaving the office I asked at the desk if I could have written directions for it and she wrote something down.

    When I got home I looked at it and realized it made no sense. So I never took it. Never saw the doc again either!

    I do agree that it appears to be somewhat like Neurontin, which I now take, but that's about all I know about it.

    Barbara
  5. klutzo

    klutzo New Member

    I have been on Neurontin for a month now, and have gained seven pounds, despite sticking to my strict diet. I am also a zombie, though I am not even at an effective dose yet. Since the last dosage increase, I have not been able to drive. So, the Neurontin has to go.
    Does Gabatril cause weight gain?
    I will probably just go back to taking straight GABA, which is much, much, cheaper and has no side-effects, but I will take the maximum dose instead of the minimum like I always did before. GABA can be bought in any good health food Store, and I think ProHealth has it here in their store also.
    I worked really hard to lose 17 lbs., and to have 7 of it come back like that without my doing anything is very depressing.
    I hope the Gabatril works for you.
    Klutzo