Vigabatrin use in psychotic epileptic patients: report of a prospective pilot study

Objectives - Evaluation of any possible behavioural reactions in epileptic patients during vigabatrin treatment. Material and methods - Ten patients w ith refractory partial epilepsy, previous mental retardation and psychosis or other significant psychiatric morbidity treated with vigabatrin were sub mitted periodically to specific tests (to quantify any possible change in b ehavioural parameters) and also to EEG recordings. Results - After 1 year o f treatment 5/10 patients became seizure-free, 3/10 of them presented reduc tion of seizures by over 75%. None of the subjects presented episodes that could be interpreted as psychotic reactions and, moreover, some patients sh owed a reduction in stereotypies, instability and aggressiveness. In 66% of these patients an improvement in cognitive functions was observed. Conclus ion - The onset of side effects can be prevented by a gradual introduction of vigabatrin and by the use of the drug in moderate doses. These data do n ot confirm the contraindication to treat with vigabatrin patients with a hi story of psychiatric disturbances.