VIGABATRIN

Vigabatrin (VGB) is a recently-released antiepileptic drug which works by a clearly-defined mechanism of action: inhibition of GABA transami nase leading to an elevation of brain GABA concentration. It has been proven effective, mainly as an add-on agent, in complex partial and se condarily generalized seizures in both adults and children as well as in infantile spasms in both short and long-term controlled studies. Wo rld-wide experience now includes over 150,000 patients exposed to the drug. VGB has a favorable pharmacokinetic profile since it has little protein-binding, is mainly excreted unchanged by the kidney and has a long effective half-life allowing once or twice daily dosing. It is ge nerally well-tolerated with very few cognitive effects but may cause s ignificant behavioral side effects such as agitation, irritability, de pression or psychosis in approximately 2-4% of cases. Mild weight gain and possible exacerbation of absence and myoclonic seizures are other reported adverse effects. The role of VGB in other childhood epilepti c syndromes apart from West syndrome is still being defined.