Tiagabine Reduces Neuropathic Pain

NEW YORK (Reuters Health) Apr 21 - The antiepileptic drug tiagabine (Gabitril; Cephalon) is effective in reducing pain due to complex regional pain syndrome type I, results of a small study suggest.

Tiagabine is a selective gamma-aminobutyric acid (GABA) reuptake inhibitor shown to have antihyperalgesic and antinociceptive effects in animal models of neuropathic pain, Dr. Raymond Sorensen and Michael G. Jenson note in their report, published in the American Journal of Pain Management for April.

The researchers, based at PETC Research Group in Tulsa, Oklahoma, treated 20 patients with complex regional pain syndrome type I -- also commonly termed reflex sympathetic dystrophy -- with tiagabine, started at 2 to 4 mg daily, escalating to doses of up to 12 mg. The patients, who were either refractory or naive to other anti-epilepsy drugs, were followed for 24 weeks.

Forty percent of subjects reported a greater than 70% reduction in symptoms on the McGill Short Form Pain Questionnaire, while 40% had a good (50% to 70%) response. Twenty percent reported less than 20% reduction in symptoms.

Three patients discontinued treatment due to nausea and one due to lack of efficacy.

"Placebo-controlled trials are needed to better assess this most promising agent," the authors conclude.

Am J Pain Manage 2005;15:66-70.

Updated 4-28-05