GAMMA-VINYL GABA (VIGABATRIN) AND MOOD DISTURBANCES

We explored factors that may predispose patients to adverse mood effec ts during treatment with vigabatrin (gamma-vinyl GABA; VGB): mood diso rders before VGB treatment, type of epilepsy, seizure type and seizure frequency, type and number of comedication, and VGB dose. The clinica l relevance of such a study is that it may help identify circumstances in which VGB should be administered with caution. Seventy-three patie nts (40 males, 33 females), all with refractory epilepsies, who receiv ed VGB as add-on therapy, were assessed by the Amsterdamse Stemmingsly st (ASL), a mood-rating scale, before the start of treatment, and demo graphic and clinical data were recorded. The patients were followed fo r 6 months after the start of VGB treatment. Treatment with VGB had to be discontinued in 38 patients (52% of the total sample). Mood proble ms were the main reason for discontinuation in 9 (12.3% of the total s ample). In 6 other patients, mood problems were mentioned as the reaso n for discontinuing treatment, in combination with lack of drug effica cy. Development of adverse mood effects could not be predicted by a sp ecific mood profile on the ASL. Before treatment, the ''mood problems discontinuation group'' did not show extreme scores for any assessed a reas of mood and no significant differences from other patients were n oted on the mood scales. Neither did clinical or demographic data show statistically confirmed specific characteristics for the mood problem s discontinuation group, though the patients tended to use more antiep ileptic drugs (AEDs) as cotherapy, to have a slightly lower daily dose of VGB, to be slightly older, and were mostly female. Especially the trend toward a relation with AED as comedication deserves further stud y.