This is not the most recent version of the article. View current version (7 DEC 2011)

Intervention Review

Tiagabine in the maintenance treatment of bipolar disorders

  1. Akshya Vasudev1,*,
  2. Karine Macritchie2,
  3. Sanjay NK Rao3,
  4. John Geddes4,
  5. Allan H Young2

Editorial Group: Cochrane Depression, Anxiety and Neurosis Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 11 FEB 2008

DOI: 10.1002/14651858.CD005173.pub2

Database Title

Additional Information

How to Cite

Vasudev A, Macritchie K, Rao SNK, Geddes J, Young AH. Tiagabine in the maintenance treatment of bipolar disorders. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD005173. DOI: 10.1002/14651858.CD005173.pub2.

Author Information

  1. 1

    Centre for Health of the Elderly, Castleside Offices, Newcastle Upon Tyne, UK

  2. 2

    University of British Columbia, Department of Psychiatry, Vancouver, Canada

  3. 3

    Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

  4. 4

    University of Oxford, Department of Psychiatry, Oxford, UK

*Akshya Vasudev, Castleside Offices, Centre for Health of the Elderly, Newcastle General Hospital, Newcastle Upon Tyne, NE4 6BE, UK. akshya38@hotmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

SEARCH

ARTICLE TOOLS

This is not the most recent version of the article.View current version (07 Dec 2011)

View Full Article (HTML) Summary (58K)Standard (170K)Full (170K)
 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

Tiagabine, an anticonvulsant, has been reported to have efficacy in prophylactic treatment of bipolar disorder in case reports and in case series.

Objectives

To review the efficacy and acceptability of tiagabine, relative to placebo, and other agents in the prevention and/or attenuation of episodes of bipolar affective disorder. The efficacy and acceptability of tiagabine were considered in terms of mood symptoms, mortality, general health, social functioning, adverse effects and overall acceptability to patients.

Search strategy

The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (CCDANCTR-Studies and CCDANCTR-References) were searched on 12/2/2008.

Reference lists of relevant papers and major textbooks of affective disorder were examined.

Authors, other experts in the field and pharmaceutical companies were contacted for knowledge of suitable published or unpublished trials.

Specialist journals and conference proceedings were handsearched.

Selection criteria

Randomised controlled trials which compare tiagabine with placebo, alternative mood stabilisers or antipsychotics, where the stated intent of intervention was the maintenance treatment of bipolar affective disorder, were sought. Bipolar patients, male and female, of all ages were to be included.

Data collection and analysis

Data were to be extracted from the original reports if they met our inclusion criteria. The main outcomes to be assessed were:

(1) The efficacy of tiagabine treatment in preventing or attenuating further episodes of bipolar affective disorder, including its efficacy in rapid cycling disorder.
(2) The acceptability of tiagabine treatment to patients.
(3) The prevalence of side effects.
(4) Mortality, if any, on tiagabine treatment.

Outcomes concerning relapse or recurrence were to be analysed excluding data from studies using discontinuation protocols, which were to be analysed separately. Sub-group analyses were to be performed to examine the effects of tiagabine treatment in rapid cycling bipolar disorder and previous mood stabiliser non-responders. Data were to be analysed using Review Manager version 4.2.8.

Main results

No randomised controlled trials of tiagabine in the maintenance treatment of bipolar disorder were found.

Authors' conclusions

There is an insufficient methodologically rigorous evidence base to provide guidance on the use of tiagabine in the maintenance treatment of bipolar disorder. There is a need for randomised controlled trials examining the therapeutic potential of this agent in bipolar disorder, after the nature of reported episodes of syncope or seizure in tiagabine-treated bipolar patients has been established.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Tiagabine in the maintenance treatment of bipolar disorder

This systematic review investigated the efficacy and acceptability of tiagabine compared to placebo and other mood stabilisers in the maintenance treatment of bipolar disorder. No randomised controlled trials were found. Currently, there is insufficient evidence on which to base any recommendations regarding the use of tiagabine in the maintenance phase of bipolar illness, either in monotherapy or as an adjunctive treatment. There is a need for randomised controlled trials examining the efficacy and acceptability of tiagabine in the maintenance treatment of bipolar disorder, after the nature of reported episodes of syncope or seizure in tiagabine-treated bipolar patients has been established.

View Full Article (HTML) Summary (58K)Standard (170K)Full (170K)