An open-label study to evaluate switching from an SSRI or SNRI to tiagabine to alleviate antidepressant-induced sexual dysfunction in generalized anxiety disorder.

BACKGROUND: This study investigated tiagabine monotherapy in subjects with generalized anxiety disorder (GAD) who had been switched from selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) as a result of antidepressant-induced sexual dysfunction.
METHODS: Adults with DSM-IV GAD, an adequate therapeutic response (> or =50% decrease in Hamilton Rating Scale for Anxiety [HAM-A] total score) to SSRI or SNRI and sexual dysfunction were switched to open-label tiagabine 4-12 mg/day for 14 weeks. Assessments included the HAM-A, Hospital Anxiety & Depression Scale (HADS) and the Arizona Sexual Experiences Scale (ASEX); assessments were made at baseline and at Weeks 4, 8, and 14.
RESULTS: Twenty six subjects were included in the analysis. Tiagabine showed no worsening in baseline symptoms of GAD, with non-significant changes from baseline in mean HAM-A total scores and HADS Anxiety and Depression subscale scores. There was a significant (p < 0.001) reduction in ASEX total scores from baseline following tiagabine, indicating an alleviation of sexual dysfunction. Tiagabine was reasonably tolerated; the most commonly reported adverse events were dizziness/light headedness (n = 6; 23%), nausea (n = 6; 23%) and fatigue (n = 2; 8%).
CONCLUSIONS: Tiagabine may be useful in subjects who respond to previous antidepressant therapy but develop sexual dysfunction as an adverse event.