An add-on antiepileptic for focal seizures
Tiagabine
An antiepileptic medicine used alongside others to help control focal (partial) seizures.
What is Tiagabine?
Tiagabine is an antiepileptic medicine used as an add-on treatment for focal (partial) seizures that are not fully controlled by other medicines. It works by boosting GABA, a calming chemical in the brain. The most important safety point is that it can trigger seizures, including prolonged seizures (status epilepticus), in people who do not have epilepsy, so it should not be used off-label for other conditions. It commonly causes dizziness and drowsiness, and it should never be stopped suddenly, as this can bring on seizures. It is prescribed and supervised by a specialist.
Education and reference only. This is a plain-language guide to Tiagabine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Tiagabine is a medicine used to help control epilepsy. It is taken alongside other antiepileptic medicines as an add-on treatment for focal (also called partial) seizures, which start in one part of the brain, when these are not fully controlled by existing treatment. It is taken by mouth. A particularly important point with tiagabine is that, while it treats seizures in people with epilepsy, it can actually cause seizures in people who do not have epilepsy, so it is not suitable for off-label use in other conditions. It is prescribed and supervised by a specialist.
How it works
The brain uses a calming chemical called GABA to keep nerve activity in balance, and in epilepsy the electrical activity can become disordered, causing seizures. Tiagabine works by stopping GABA being taken back up too quickly, so more of it stays active and helps calm the overactive nerve signalling. This makes seizures less likely in people with epilepsy. The same effect on brain chemistry, however, can paradoxically trigger seizures in people who do not have epilepsy, which is why tiagabine is reserved for treating epilepsy under specialist care.
Company & origin
Originated / developed by: Specialist manufacturer.
An antiepileptic medicine used in the UK as an add-on treatment for focal (partial) seizures that are not fully controlled by other medicines.
What it treats
Conditions Tiagabine is used for
Practical use
How to take Tiagabine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, usually with food, at evenly spaced times each day.
- Do not stop taking it suddenly, as this can bring on seizures; any change is made gradually with specialist advice.
- Be aware it can cause dizziness and drowsiness, so take care with driving and machinery until you know how it affects you.
- Report any new or worsening low mood or thoughts of self-harm to your prescriber promptly.
- Tell your prescriber about all your other medicines, as some can affect how tiagabine works.
Weighing it up
Advantages & disadvantages of Tiagabine
Advantages
- Can help control focal (partial) seizures when added to other antiepileptic medicines.
- Offers another option for people whose seizures are not fully controlled.
- Taken by mouth as part of a combined epilepsy treatment plan.
Disadvantages
- Can trigger seizures, including prolonged seizures, in people who do not have epilepsy, so must not be misused.
- Commonly causes dizziness, drowsiness and tiredness.
- Must not be stopped suddenly, as this can bring on seizures.
Practical use
Good to know
The most important safety point with tiagabine is that it can trigger seizures, including prolonged or repeated seizures known as status epilepticus, in people who do not have epilepsy. Because of this, it must not be used off-label for conditions other than epilepsy, and it should only be used as intended. Like many antiepileptics, it commonly causes dizziness, drowsiness, tiredness and sometimes problems with concentration, especially when first started or when the dose is changed. A crucial point is that it should never be stopped suddenly, as stopping an antiepileptic abruptly can bring on seizures; any change is made gradually under specialist guidance. As with all antiepileptics, any new or worsening low mood or thoughts of self-harm should be reported promptly. Tell your prescriber about all your other medicines.
Who should not take it / use with caution
- It should not be used to treat conditions other than epilepsy, as it can trigger seizures in people without epilepsy.
- People who have had a serious allergic reaction to tiagabine should not take it.
- It is used with caution in people with liver problems and under careful specialist supervision.
Monitoring
- Reviewing how well seizures are controlled and how the medicine is tolerated.
- Watching for side effects such as dizziness, drowsiness and changes in mood.
- Reviewing other medicines, as they can affect tiagabine levels.
Side effects
- Dizziness, drowsiness and tiredness, especially early in treatment or when the dose changes.
- Problems with concentration, low mood, or shakiness in some people.
- Rarely, prolonged or repeated seizures, which is more of a risk when it is used inappropriately.
Key interactions
- Other antiepileptic medicines can change tiagabine's level in the body, so doses are adjusted with care.
- Alcohol and other sedating medicines add to drowsiness and dizziness.
- Tell your prescriber about all your medicines, as several can affect how tiagabine works.
Available as: Tablets taken by mouth.
Answers
Tiagabine: frequently asked questions
What is tiagabine used for?
It is used as an add-on antiepileptic medicine, alongside others, to help control focal (partial) seizures that are not fully controlled.
Why can it cause seizures in people without epilepsy?
Its effect on brain chemistry can paradoxically trigger seizures, including prolonged ones, in people who do not have epilepsy, which is why it must not be used off-label.
Can I stop it suddenly if I feel better?
No. Stopping an antiepileptic suddenly can bring on seizures, so any change must be made gradually under specialist guidance.
Will it make me drowsy?
Dizziness, drowsiness and tiredness are common, especially when starting or changing the dose, so take care with driving and machinery.
Is it used on its own?
It is generally used as an add-on alongside other antiepileptic medicines rather than on its own.
Authoritative sources
- BNF
- NICE CKS
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