US Brand Name: Gabitril

generic name: tiagabine hydrochloride

Class: Antieplieptic drug (AED)/ Anticonvulsant (AC)

1.  Other brand names & branded generic names¹

Gabatril (Mexico)

2.  FDA Approved Uses

Adjunctive treatment (i.e. you must use another drug along with it) for types of partial epileptic seizures in adults and kids over 12.

3.  Off-Label Uses of

• Monotherapy (used by itself) treatment of epilepsy that doesn’t respond to other meds.
• PTSD.
• Generalized Anxiety Disorder (with or without comorbid depression, compared well with Paxil.
• Cocaine abuse.
• Impulse Control Disorder.
• Neuropathy.
• Bipolar Disorder - it’s typically a bust.

4.  pros and cons

4.1  Pros

It might make you feel like you’ve had a margarita for breakfast, but apparently you can safely drink while taking it. It doesn’t have much in the way of drug-drug interactions (just a slight lowering of the valproate medications (Depakene (valproic acid), Depakote (divalproex sodium) or Depacon (valproate sodium) plasma levels). It also doesn’t mess with oral contraceptives. Like Neurontin (gabapentin) the side effect profile is generally low.

4.2  Cons

If the side effects do hit you this is a stupid pill that ranks up there with Topamax (topiramate) and Zonegran (zonisamide). Can work for a week or two for some off-label uses, then just quit on you.

5.  Side Effects

5.1  Typical Side Effects

The usual for anticonvulsants. Nausea, diarrhea and other tummy troubles, which are usually short term. Feeling drunk. There’s no other way to describe it, the first week on Gabitril (tiagabine) is like drinking good Scotch for breakfast. Eventually it wore down to a pleasant beer buzz, but when that wore off, so did all of its beneficial effects. An intense lethargy and sedation that’s proven to be short-term for the vast majority of people, but lingering lethargy and sedation may or may not stick around for you.

5.2  Not So Common Side Effects

Gabitril (tiagabine) can make you stupid like you can’t imagine. Mouse forgot where we lived. I had to talk her home, street by street, from ten blocks away. Add that to the feeling drunk and you can see why “accidental injury” is in the PI sheet.

5.3  Freaky Rare Side Effects

Loss of taste - it happened to me. Non-convulsive status epilepticus.

6.  Interesting Stuff Your Doctor Probably Won’t Tell You

• I seriously doubt that your doctor will tell you that, unlike most other anticonvulsants, it seems to be OK to mix booze and Gabitril (tiagabine). But who knows?
• Gabitril (tiagabine) works better in the daytime than at night. No, really. It’s in the PI sheet. “A diurnal effect on the pharmacokinetics of tiagabine was observed. Mean steady-state Cmin values were 40% lower in the evening than in the morning. Tiagabine steady-state AUC values were also found to be 15% lower following the evening tiagabine dose compared to the AUC following the morning dose” If you’re subject to nocturnal seizures (or if taking it off-label and whatever you’re treating gets worse at night, as some stuff does) discuss with your doctor adjusting your dosage schedule so you take a little more in the evening and at night than in the day.

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7.  Gabitril’s Dosage and How to Take Gabitril

The published dosage schedule was based upon patients taking an enzyme-inducing anticonvulsant such as Trileptal (oxcarbazepine), Tegretol (carbamazepine USP), Dilantin (phenytonin) or good old phenobarbital. If you’re not taking one of these meds Cephalon recommends “lower doses or a slower titration of tiagabine for clinical response.” Hey, how about both!

So instead of starting at 4mg and increasing by 4–8mg a week, you might consider starting at 2mg, and increasing by 2–4mg every two weeks to start.

Gabitril (tiagabine) should be taken with food. Divide the doses into 2–4 doses a day.

The maximum dosage is 56mg a day.

8.  How Long Gabitril Takes to Work

Like all anticonvulsants it works best once you reach the proper dosage. That’s usually in the range of 32–56mg a day. But you might be getting relief at lower dosages, especially for off-label uses.

9.  How to Stop Taking Gabitril

Your doctor should be recommending that you reduce your dosage by 4mg a day every other day.

Cephalon is vague, like most drug companies, on how you should discontinue an anticonvulsant. They tested doing so over a four week period. From 56mg a day that would be stepping down 4mg a day every other day. Works for me!

Like any anticonvulsant, if you’ve been taking Gabitril (tiagabine) for more than a couple months and you’re up to or above 16mg a day (give or take, depending on other meds you might be taking) you just can’t stop cold turkey if you’re not at the therapeutic dosage for another anticonvulsant that you know works for you, otherwise you risk partial-complex, absence seizures or even tonic-clonic grand mals, despite your never having had a seizure disorder before! The risk is worse if you’re taking a lithium variant, and/or any antidepressant, especially Wellbutrin (bupropion hydrochloride). Anyone with a history of a seizure disorder who needs to stop taking an anticonvulsant cold turkey needs to be discussing that with two neurologists and not getting your information from some stupid web site. Get off your computer and start making appointments!

10.  Gabitril’s Half-Life & Average Time to Clear Out of Your System

Half-life of 7–9 hours if you’re not taking an enzyme-inducing anticonvulsant such as Tegretol or Eilantin (phenytonin). Otherwise the half-life is 3–4.5 hours. So it’s out of your system in either 2 days or 1 day. Either way, it’s gone pretty quickly.

11.  Days to Reach a Steady State

Usually two to three days.

12.  Discussion board

Crazy Meds’ Gabitril discussion board

13.  Your Comments About and Experiences with Gabitril

Tell us what you think about Gabitril

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Enter your own Comments & Experiences with Gabitril here.
You must be a registered member of the Crazy Meds Talk forum to post a comment on this page.

14.  Full US PI sheet, Global SPCs & PILs, check for drug-drug interactions

Gabitril Full US Prescribing Information / PI Sheet

Check for drug-drug interactions

15.  Bibliography

Physicians’ Desk Reference Edition 56 Maria Deutsch & Anu Gupta, Drug Information Specialists, et al. © 2002. Published by Medical Economics Company.

Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton

A Primer of Drug Action Robert M. Julien, M.D., Ph. D. © 2001. Ninth Edition.

The Complete Guide to Psychiatric Drugs Edward Drummond, M.D. © 2000. Published by John Wiley & Sons, Inc.

Mosby’s 2004 Drug Guide David Nissen PharmD, Editor.© 2004. An imprint of Elsevier.

¹ The term "branded generic" has three meanings:
1) A generic drug produced by a generics manufacturer that is a wholly-owned subsidiary of the company that makes the branded version. E.g. Greenstone Pharmaceuticals makes gabapentin, and they are owned by Pfizer, who also own Parke-Davis, the makers of Neurontin.
2) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Teva's Budeprion), but otherwise has the same active ingredient as the original branded version (Wellbutrin).
3) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Sanofi-Aventis' Aplenzin, which is bupropion hydrobromide) and uses a salt of the active ingredient that is different from the original branded version and other generics (Wellbutrin, Budeprion and all the others are bupropion hydrochloride). We aren't sure if that really makes a difference or not. The FDA says they're the same thing. As usual, the data are contradictory, but most evidence indicates that the FDA is right and the differences are negligible.
For our purposes a "branded generic name" refers to the second and third definitions.

Date created 25 Apr 2011 - 14:26 Page Creator: JerodPoore Last edited by:

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Almost all of the material on this site is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.

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Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
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Crazy Meds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Firefox or Safari, which is what a plurality of visitors use. And I’m running Windows XP3. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazy Meds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazy Meds is not responsible for whatever weird shit your browser does or does not do when you read this site².
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¹ While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

² Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]