Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1990 Dec;53(12):1051–1055. doi: 10.1136/jnnp.53.12.1051

Vigabatrin: rational treatment for chronic epilepsy.

H A Ring 1, A J Heller 1, I N Farr 1, E H Reynolds 1
PMCID: PMC488313  PMID: 2292696

Abstract

Vigabatrin is a selective, irreversible suicide inhibitor of GABA transaminase and thus increases brain and CSF GABA. In 33 adult patients with long standing refractory epilepsy on treatment with one or two standard anti-convulsant drugs, the addition of vigabatrin up to 3g daily for eight weeks was associated with a 48.2% reduction in seizure frequency. Twenty patients who had exhibited a 50% or more reduction in frequency of one or more seizure types entered an eight week double-blind placebo controlled phase. Patients on vigabatrin maintained a 54.7% reduction of seizure frequency, whereas those on placebo showed an 18.6% increase in seizure frequency, a highly significant difference between the two groups. In the open phase, seven patients were withdrawn due to unacceptable and reversible adverse events. The commonest side effects were drowsiness, depression and mood instability, and headaches. Vigabatrin is a potentially valuable new treatment for chronic epilepsy, especially partial seizures with or without secondary generalisation.

Full text

PDF
1051

Selected References

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

  1. Albus M., von Gellhorn K., Münch U., Naber D., Ackenheil M. A double-blind study with ceruletide in chronic schizophrenic patients: biochemical and clinical results. Psychiatry Res. 1986 Sep;19(1):1–7. doi: 10.1016/0165-1781(86)90086-7. [DOI] [PubMed] [Google Scholar]
  2. Amery W., Dony J. A clinical trial design avoiding undue placebo treatment. J Clin Pharmacol. 1975 Oct;15(10):674–679. doi: 10.1002/j.1552-4604.1975.tb05919.x. [DOI] [PubMed] [Google Scholar]
  3. 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]
  4. Butler W. H., Ford G. P., Newberne J. W. A study of the effects of vigabatrin on the central nervous system and retina of Sprague Dawley and Lister-Hooded rats. Toxicol Pathol. 1987;15(2):143–148. doi: 10.1177/019262338701500203. [DOI] [PubMed] [Google Scholar]
  5. Dreifuss F. E. Report on the International League Against Epilepsy. Epilepsia. 1986 Jan-Feb;27(1):1–2. doi: 10.1111/j.1528-1157.1986.tb03493.x. [DOI] [PubMed] [Google Scholar]
  6. Gram L., Klosterskov P., Dam M. gamma-Vinyl GABA: a double-blind placebo-controlled trial in partial epilepsy. Ann Neurol. 1985 Mar;17(3):262–266. doi: 10.1002/ana.410170307. [DOI] [PubMed] [Google Scholar]
  7. Gram L., Lyon B. B., Dam M. Gamma-vinyl-GABA: a single-blind trial in patients with epilepsy. Acta Neurol Scand. 1983 Jul;68(1):34–39. doi: 10.1111/j.1600-0404.1983.tb04812.x. [DOI] [PubMed] [Google Scholar]
  8. Hauw J. J., Trottier S., Boutry J. M., Sun P., Sazdovitch V., Duyckaerts C. The neuropathology of vigabatrin. Br J Clin Pract Suppl. 1988 Mar;61:10–13. [PubMed] [Google Scholar]
  9. Jung M. J., Lippert B., Metcalf B. W., Böhlen P., Schechter P. J. gamma-Vinyl GABA (4-amino-hex-5-enoic acid), a new selective irreversible inhibitor of GABA-T: effects on brain GABA metabolism in mice. J Neurochem. 1977 Nov;29(5):797–802. doi: 10.1111/j.1471-4159.1977.tb10721.x. [DOI] [PubMed] [Google Scholar]
  10. Meldrum B. S. Gamma-aminobutyric acid and the search for new anticonvulsant drugs. Lancet. 1978 Aug 5;2(8084):304–306. doi: 10.1016/s0140-6736(78)91703-8. [DOI] [PubMed] [Google Scholar]
  11. Pedersen B., Højgaard K., Dam M. Vigabatrin: no microvacuoles in a human brain. Epilepsy Res. 1987 Jan;1(1):74–76. doi: 10.1016/0920-1211(87)90054-4. [DOI] [PubMed] [Google Scholar]
  12. Rimmer E. M., Richens A. Double-blind study of gamma-vinyl GABA in patients with refractory epilepsy. Lancet. 1984 Jan 28;1(8370):189–190. doi: 10.1016/s0140-6736(84)92112-3. [DOI] [PubMed] [Google Scholar]
  13. Schechter P. J., Hanke N. F., Grove J., Huebert N., Sjoerdsma A. Biochemical and clinical effects of gamma-vinyl GABA in patients with epilepsy. Neurology. 1984 Feb;34(2):182–186. doi: 10.1212/wnl.34.2.182. [DOI] [PubMed] [Google Scholar]
  14. Tartara A., Manni R., Galimberti C. A., Hardenberg J., Orwin J., Perucca E. Vigabatrin in the treatment of epilepsy: a double-blind, placebo-controlled study. Epilepsia. 1986 Nov-Dec;27(6):717–723. doi: 10.1111/j.1528-1157.1986.tb03600.x. [DOI] [PubMed] [Google Scholar]
  15. Tassinari C. A., Michelucci R., Ambrosetto G., Salvi F. Double-blind study of vigabatrin in the treatment of drug-resistant epilepsy. Arch Neurol. 1987 Sep;44(9):907–910. doi: 10.1001/archneur.1987.00520210009010. [DOI] [PubMed] [Google Scholar]

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

RESOURCES