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GABA-Ergic Drugs: Exit Stage Left, Enter Stage Right

Allan H. Young

Department of Psychiatry, University of Newcastle upon Tyne, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Drugs that enhance -aminobutyric acid (GABA) activity by interacting at post-synaptic GABA_A receptors have long been used as hypnotics, sedatives, tranquillizers and anticonvulsants. In this category, benzodiazepines rapidly gained pride of place, replacing barbiturates and becoming the most commonly prescribed of all drugs in the Western world in the 1970s. However, problems such as dependence and withdrawal reactions became apparent in the 1980s, and it seemed that the usefulness of drugs with this mode of action was limited. Recently, focus has shifted to a new group of drugs with GABA-ergic actions mediated through various mechanisms not directly involving the GABA_A receptor. These drugs include gabapentin, vigabatrin, tiagabine, lamotrigine, pregabalin and others. Although originally developed as anticonvulsants for epilepsy, they appear to have wider applications for use in affective disorders, especially bipolar depression, anxiety disorders and pain conditions. The current information on the properties and therapeutic potential of this new generation of GABA-ergic drugs is reviewed. It remains to be seen whether long-term use leads to tolerance, dependence and withdrawal or discontinuation reactions.

Key Words: affective disorders • anticonvulsants • anxiety disorders • chronic pain • GABA-ergic drugs • gabapentin • lamotrigine • pregabalin • tiagabine • vigabatrin

Journal of Psychopharmacology, Vol. 17, No. 2, 174-178 (2003)
DOI: 10.1177/0269881103017002004


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