Switching From an SSRI to Tiagabine(GABITRIL) in Order to Alleviate SSRI Induced Sexual Dysfunction
Status:
Completed
Trial end date:
2005-05-01
Target enrollment:
Participant gender:
Summary
Anxious patients are now treated with Selective Serotonin Reuptake Inhibitor medications
(common antidepressants) which elevate serotonin and thus alleviate anxiety. These
medications have clearly proven efficacy upwards of 70% for many anxiety disorders. In
regards to tolerability, they have a major problem in that they often produce sexual
dysfunction in men and women (ie. decreased libido, anorgasmia, impotence) upwards of 30% of
the time.
Benzodiazepine anxiolytics are also FDA approved to treat anxiety with equal efficacy and
greater tolerability (very little, if any sexual dysfunction). They do, however, carry a
substantial risk for addiction. Tiagabine is a Selective GABA Reuptake Inhibitor (SGRI) that
is FDA approved to treat certain types of epilepsy. Like benzodiazepines, Tiagabine also
increases the neurotransmitter, GABA, in the brain and is thought to alleviate anxiety (see
references below) this way too, but without any addiction risk common to Valium-type drugs.
The safety profile of Tiagabine is thought to be much safer. Two double blind studies are
ongoing which are looking at Tiagabine's effectiveness in PTSD and GAD. There are many open
label studies showing anxiety reduction and many psychiatrists in clinical practice are
utilizing this agent as an anxiety treatment in an off-label manner.
This study is designed to evaluate anxious patients who are taking SSRI medication, have had
a reasonable response, but are experiencing significant sexual side effects which are pushing
them towards noncompliance and possible relapse into anxiety. 30 subjects (15 men and 15
women) will be asked to join the study and be placed on Tiagabine as well as their current
SSRI. Once an acceptable dose of Tiagabine is reached in the first four weeks, the subjects'
SSRIs will be slowly stopped. Two weeks after enrollment, all subjects will be called in
order to check for any side effects to the study drug and to insure that each subject is
titrating to the proper dose of study drug according to the study protocol. An open-label,
non-placebo prospective 10 week follow up will occur, where the now Tiagabine monotherapy
subjects will be followed to see primarily if their sexual dysfunction improves and if there
anxiety remains controlled.
Phase:
Phase 4
Details
Lead Sponsor:
State University of New York - Upstate Medical University