VIGABATRIN AND BEHAVIOR DISORDERS - A RETROSPECTIVE SURVEY

Vigabatrin is an anticonvulsant drug with a relatively favourable side -effect profile. However, in clinical trials behaviour disorders have been reported, including agitation, depression and psychoses. In this study, 136 cases of behavioural problems that had been reported to the manufacturers, or the authors, were followed up. Satisfactory clinica l information could be obtained on 81 patients. Of these, 50 cases met the criteria for either a psychosis (n = 28) or depression (n = 22). These were compared with a group of Queen Square patients, with epilep sy and psychosis, who had never taken vigabatrin (n = 21) and another group, who received vigabatrin without experiencing any behavioural pr oblems (n = 28). The main results from this study suggest that: (1) Ps ychosis as a treatment emergent effect of vigabatrin is seen in patien ts with more severe epilepsy, compared with those patients who never d evelop psychopathology, and those developing an affective disorder. Th e psychosis is related to a right-sided EEG focus, and suppression of seizures (64% became seizure free). (2) Depression as a treatment emer gent effect of vigabatrin is associated with a past history of depress ive illness. There was little or no change in seizure frequency in thi s group. Some suggestions for managing patients who may develop these behaviour disorders are given.