THE EFFECT OF NON-DEPOT ACTH(1-24) ON INFANTILE SPASMS

ACTH used in a depot form has been shown to be effective in the treatm ent of infantile spasms. However, side-effects such as severe infectio ns, hypertension and electrolyte imbalance have been found, assumed to be related to hypercortisolism induced by chronic ACTH treatment. The authors treated 18 patients with infantile spasms with non-depot ACTH (1-24). The therapeutic effect of non-depot ACTH was comparable to tha t of depot ACTH, with no severe bacterial infection or sepsis. The inc idence of hypertension was significantly lower in the non-depot ACTH g roup, and persistent hypercortisolaemia was not found. Non-depot ACTH( 1-24) appears to be as effective as ACTH(1-24) depot therapy in the tr eatment of infantile spasms, and its side-effects are mild. It would a ppear that the effect of non-depot ACTH is not mediated by hypercortis olism, but by a direct neurotropic effect on the brain.