Schaller James L, Thomas John, Rawlings David
Professional Medical Services of Naples, Naples, Florida, USA.
MedGenMed. 2004 Sep 17;6(3):8.
Gamma-aminobutyric acid (GABA), the predominant inhibitory neurotransmitter of the central nervous system, is involved in the pathophysiology of a wide variety of disorders, including anxiety. Tiagabine hydrochloride acts as a selective GABA reuptake inhibitor (SGRI).
Consecutive patients were offered tiagabine in 1-mg incremental doses for the treatment of anxiety, primarily generalized anxiety disorder. Individuals failing anxiety treatment with benzodiazepines, selective serotonin reuptake inhibitors, and buspirone, and/or with a strong family or personal history of substance abuse were allowed trials. The SGRI tiagabine improved anxiety and was well tolerated by adult patients with generalized anxiety disorder as well as one patient with anxiety secondary to acute antidepressant withdrawal. One disinhibition treatment failure is also discussed.
In acute anxiety treatment, very low initial dosing with gradual increases may be sufficient for anxiety effects, when compared with the higher doses of tiagabine used in epilepsy treatment. Tiagabine may be useful in the treatment of generalized anxiety disorder.
γ-氨基丁酸（GABA）是中枢神经系统主要的抑制性神经递质，参与包括焦虑症在内的多种疾病的病理生理过程。盐酸噻加宾是一种选择性GABA再摄取抑制剂（SGRI）。
连续纳入患者，给予递增剂量的噻加宾（每次增加1mg）用于治疗焦虑症，主要是广泛性焦虑症。允许对使用苯二氮䓬类药物、选择性5-羟色胺再摄取抑制剂和丁螺环酮治疗焦虑症无效，和/或有强烈的药物滥用家族史或个人史的个体进行试验。SGRI噻加宾改善了焦虑症状，广泛性焦虑症成年患者以及1例急性抗抑郁药撤药继发焦虑的患者对其耐受性良好。还讨论了1例脱抑制治疗失败的情况。
在急性焦虑症治疗中，与用于癫痫治疗的较高剂量噻加宾相比，极低的初始剂量并逐渐增加可能足以产生抗焦虑效果。噻加宾可能对治疗广泛性焦虑症有用。
