Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1993 Dec;56(12):1271–1275. doi: 10.1136/jnnp.56.12.1271

Effect of vigabatrin on sedation and cognitive function in patients with refractory epilepsy.

R A Gillham 1, J Blacklaw 1, P J McKee 1, M J Brodie 1
PMCID: PMC1015372  PMID: 8270925

Abstract

Twenty-four patients with refractory epilepsy on one or more antiepileptic drugs were given additional vigabatrin (1 g twice daily for six weeks, followed by 1.5 g twice daily for a further six weeks) and matched placebo in a double blind, randomised, crossover study. A battery of neuropsychological tests was administered at baseline and at weeks two, six and 12 of both treatment periods. No significant differences were found between vigabatrin and placebo at any time point for any of the objective tests of cognitive function. Patients, however, reported a greater degree of sedation after two and six weeks on vigabatrin than during the equivalent placebo phase (p < 0.01), although no such difference was apparent at 12 weeks. Follow up over a mean of 14.75 months in 12 responders, who continued on vigabatrin, revealed a significant improvement (all p < 0.01) on each of three composite scales (three psychomotor tests, four memory tests, three self rating scales) compared with their scores during the double blind trial. Vigabatrin did not cause cognitive impairment either acutely or in the long term. Phased introduction, however, seems a prudent policy to allow tolerance to early subjective sedation.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agosti R., Yasargil G., Egli M., Wieser H. G., Wiestler O. D. Neuropathology of a human hippocampus following long-term treatment with vigabatrin: lack of microvacuoles. Epilepsy Res. 1990 Jul;6(2):166–170. doi: 10.1016/0920-1211(90)90092-a. [DOI] [PubMed] [Google Scholar]
  2. Brodie M. J., McKee P. J. Vigabatrin and psychosis. Lancet. 1990 May 26;335(8700):1279–1279. doi: 10.1016/0140-6736(90)91342-8. [DOI] [PubMed] [Google Scholar]
  3. Brodie M. J., McPhail E., Macphee G. J., Larkin J. G., Gray J. M. Psychomotor impairment and anticonvulsant therapy in adult epileptic patients. Eur J Clin Pharmacol. 1987;31(6):655–660. doi: 10.1007/BF00541291. [DOI] [PubMed] [Google Scholar]
  4. Browne T. R., Mattson R. H., Penry J. K., Smith D. B., Treiman D. M., Wilder B. J., Ben-Menachem E., Napoliello M. J., Sherry K. M., Szabo G. K. Vigabatrin for refractory complex partial seizures: multicenter single-blind study with long-term follow-up. Neurology. 1987 Feb;37(2):184–189. doi: 10.1212/wnl.37.2.184. [DOI] [PubMed] [Google Scholar]
  5. Butler W. H. The neuropathology of vigabatrin. Epilepsia. 1989;30 (Suppl 3):S15–S17. doi: 10.1111/j.1528-1157.1989.tb05827.x. [DOI] [PubMed] [Google Scholar]
  6. Cocito L., Maffini M., Perfumo P., Roncallo F., Loeb C. Vigabatrin in complex partial seizures: a long-term study. Epilepsy Res. 1989 Mar-Apr;3(2):160–166. doi: 10.1016/0920-1211(89)90044-2. [DOI] [PubMed] [Google Scholar]
  7. Dam M. Long-term evaluation of vigabatrin (gamma vinyl GABA) in epilepsy. Epilepsia. 1989;30 (Suppl 3):S26–S30. doi: 10.1111/j.1528-1157.1989.tb05830.x. [DOI] [PubMed] [Google Scholar]
  8. Gibson J. P., Yarrington J. T., Loudy D. E., Gerbig C. G., Hurst G. H., Newberne J. W. Chronic toxicity studies with vigabatrin, a GABA-transaminase inhibitor. Toxicol Pathol. 1990;18(2):225–238. doi: 10.1177/019262339001800201. [DOI] [PubMed] [Google Scholar]
  9. Gillham R. A., Williams N., Wiedmann K. D., Butler E., Larkin J. G., Brodie M. J. Cognitive function in adult epileptic patients established on anticonvulsant monotherapy. Epilepsy Res. 1990 Dec;7(3):219–225. doi: 10.1016/0920-1211(90)90018-q. [DOI] [PubMed] [Google Scholar]
  10. Gillham R. A., Williams N., Wiedmann K., Butler E., Larkin J. G., Brodie M. J. Concentration-effect relationships with carbamazepine and its epoxide on psychomotor and cognitive function in epileptic patients. J Neurol Neurosurg Psychiatry. 1988 Jul;51(7):929–933. doi: 10.1136/jnnp.51.7.929. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Grant S. M., Heel R. C. Vigabatrin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in epilepsy and disorders of motor control. Drugs. 1991 Jun;41(6):889–926. doi: 10.2165/00003495-199141060-00007. [DOI] [PubMed] [Google Scholar]
  12. McGuire A. M., Duncan J. S., Trimble M. R. Effects of vigabatrin on cognitive function and mood when used as add-on therapy in patients with intractable epilepsy. Epilepsia. 1992 Jan-Feb;33(1):128–134. doi: 10.1111/j.1528-1157.1992.tb02295.x. [DOI] [PubMed] [Google Scholar]
  13. Pedersen S. A., Klosterskov P., Gram L., Dam M. Long-term study of gamma-vinyl GABA in the treatment of epilepsy. Acta Neurol Scand. 1985 Sep;72(3):295–298. doi: 10.1111/j.1600-0404.1985.tb00873.x. [DOI] [PubMed] [Google Scholar]
  14. Reynolds E. H., Ring H. A., Farr I. N., Heller A. J., Elwes R. D. Open, double-blind and long-term study of vigabatrin in chronic epilepsy. Epilepsia. 1991 Jul-Aug;32(4):530–538. doi: 10.1111/j.1528-1157.1991.tb04688.x. [DOI] [PubMed] [Google Scholar]
  15. Ring H. A., Heller A. J., Farr I. N., Reynolds E. H. Vigabatrin: rational treatment for chronic epilepsy. J Neurol Neurosurg Psychiatry. 1990 Dec;53(12):1051–1055. doi: 10.1136/jnnp.53.12.1051. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Sander J. W., Trevisol-Bittencourt P. C., Hart Y. M., Shorvon S. D. Evaluation of vigabatrin as an add-on drug in the management of severe epilepsy. J Neurol Neurosurg Psychiatry. 1990 Nov;53(11):1008–1010. doi: 10.1136/jnnp.53.11.1008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Sivenius J., Ylinen A., Murros K., Mumford J. P., Riekkinen P. J. Vigabatrin in drug-resistant partial epilepsy: a 5-year follow-up study. Neurology. 1991 Apr;41(4):562–565. doi: 10.1212/wnl.41.4.562. [DOI] [PubMed] [Google Scholar]
  18. Sivenius M. R., Ylinen A., Murros K., Matilainen R., Riekkinen P. Double-blind dose reduction study of vigabatrin in complex partial epilepsy. Epilepsia. 1987 Nov-Dec;28(6):688–692. doi: 10.1111/j.1528-1157.1987.tb03701.x. [DOI] [PubMed] [Google Scholar]
  19. Tartara A., Manni R., Galimberti C. A., Mumford J. P., Iudice A., Perucca E. Vigabatrin in the treatment of epilepsy: a long-term follow-up study. J Neurol Neurosurg Psychiatry. 1989 Apr;52(4):467–471. doi: 10.1136/jnnp.52.4.467. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES