Tiagabine for posttraumatic stress disorder: effects of open-label and double-blind discontinuation treatment

Connor, Kathryn M.; Davidson, Jonathan; Weisler, Richard H.; Zhang, Wei; Abraham, Kurian

doi:10.1007/s00213-005-0265-3

Cited by 76 publications

(42 citation statements)

References 42 publications

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“…Higher scores corresponded to greater resilience. The CD-RISC has been tested in both community and clinical samples and has demonstrated good internal consistency (Cronbach α = 0.89) and test-retest reliability (r = 0.87) [21]. Cronbach α for the present sample was 0.94.…”

Section: Measures Unique To Preseparation Surveysmentioning

confidence: 72%

Prospective prediction of functional difficulties among recently separated Veterans

Larson

Norman

2014

J Rehabil Res Dev

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Abstract-Reports of functional problems are common amongVeterans who served post-9/11 (more than 25% report functional difficulties in at least one domain). However, little prospective work has examined the risk and protective factors for functional difficulties among Veterans. In a sample of recently separated Marines, we used stepwise logistic and multiple regressions to identify predictors of functional impairment, including workrelated problems, financial problems, unlawful behavior, activity limitations due to mental health symptoms, and perceived difficulty reintegrating into civilian life. Posttraumatic stress disorder symptoms assessed both before and after military separation significantly predicted functional difficulties across all domains except unlawful behavior. Certain outcomes, such as unlawful behavior and activity limitations due to mental health symptoms, were predicted by other or additional predictors. Although several forms of functioning were examined, the list was not exhaustive. The results highlight a number of areas where targeted interventions may facilitate the reintegration of military servicemembers into civilian life.

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Section: Measures Unique To Preseparation Surveysmentioning

confidence: 72%

Prospective prediction of functional difficulties among recently separated Veterans

Larson

Norman

2014

J Rehabil Res Dev

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“…These explanations are consistent with other clinical studies that have suggested altered GABAergic function in PTSD. 1,7,10 A reduced GABAergic function can also be explained by the presence of increased levels of GABA.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] A putative role of GABA in PTSD is also supported by treatment studies with other GABAergic compounds, such as tiagabine, a selective GABA reuptake inhibitor. 10,11 Neuroimaging techniques provide a unique opportunity to investigate receptor binding and neurotransmitter release in vivo. Only a few neuroimaging studies of the benzodiazepine-GABA A receptor in PTSD have been performed and all these studies used single photon emission computed tomography (SPECT) and [ 123 I]iomazenil.…”

Section: Introductionmentioning

confidence: 99%

Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder

et al. 2007

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c-Aminobutyric acid (GABA A ) receptors are thought to play an important role in modulating the central nervous system in response to stress. Animal data have shown alterations in the GABA A receptor complex by uncontrollable stressors. SPECT imaging with benzodiazepine ligands showed lower distribution volumes of the benzodiazepine-GABA A receptor in the prefrontal cortex of patients with post-traumatic stress disorder (PTSD) in one, but not in another study. The objective of the present study was to assess differences in the benzodiazepine-GABA A receptor complex in veterans with and without PTSD using [ 11 C]flumazenil and positron emission tomography (PET). Nine drug naive male Dutch veterans with deployment related PTSD and seven male Dutch veterans without PTSD were recruited, and matched for age, region and year of deployment. Each subject received a [ 11 C]flumazenil PET scan and a structural magnetic resonance imaging scan. Dynamic 3D PET scans with a total duration of 60 min were acquired, and binding in template based and manually defined regions of interest (ROI) was quantified using validated plasma input and reference tissue models. In addition, parametric binding potential images were compared on a voxel-by-voxel basis using statistical parametric mapping (SPM2). ROI analyses using both template based and manual ROIs showed significantly reduced [ 11 C]flumazenil binding in PTSD subjects throughout the cortex, hippocampus and thalamus. SPM analysis confirmed these results. The observed global reduction of [ 11 C]flumazenil binding in patients with PTSD provides circumstantial evidence for the role of the benzodiazepine-GABA A receptor in the pathophysiology of PTSD and is consistent with previous animal research and clinical psychopharmacological studies.

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“…Á The anticonvulsant valproate was not effective in a DBPC study (Davis et al 2008a) (E). Á The selective GABA reuptake inhibitor anticonvulsant tiagabine did not seem to have an effect (Connor et al 2006a;Davidson et al 2007a) (E). Á Assuming hyperactivity of the norepinephrine system in patients with PTSD, the a 2 -adrenergic agonist guanfacine was tested in PTSD, but the results were negative (Davis et al 2008b;Neylan et al 2006…”

Section: )(D)mentioning

confidence: 96%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

712

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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Tiagabine for posttraumatic stress disorder: effects of open-label and double-blind discontinuation treatment

Abstract: These findings suggest a possible role for the SGRI tiagabine in the treatment of PTSD. As the role of GABAergic drugs in PTSD is poorly defined, larger, randomized, double-blind, placebo-controlled trials are needed.

Cited by 76 publications

References 42 publications

Prospective prediction of functional difficulties among recently separated Veterans

Prospective prediction of functional difficulties among recently separated Veterans

Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

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