Vigabatrin: An Anticonvulsant for Epilepsy and Seizures
Vigabatrin is an anticonvulsant used to treat refractory epilepsy and infantile spasms. It is effective in controlling partial seizures and is particularly useful in patients who have not responded to other medications.
Mechanism of Action
Vigabatrin works by irreversibly inhibiting GABA transaminase, the enzyme that breaks down GABA, an inhibitory neurotransmitter in the brain. This results in increased levels of GABA, which stabilizes neuronal activity and prevents seizures.
Indications
● Refractory Epilepsy: For treating partial-onset seizures that are not controlled by other medications.
● Infantile Spasms: For treating infantile spasms associated with West Syndrome.
Dosage and Administration
● Adults: Typically 500–2,000 mg/day in divided doses for seizure management.
●Pediatric Dosage: Adjusted based on age and condition, starting at 25–50 mg/kg/day. Maximum dose is 75 mg/kg/dose BID or 150 mg/kg/day. The drug is not abrupted suddenly but slowly discontinued by reducing the dose.
Side Effects
● Common: Drowsiness, dizziness, fatigue, and irritability.
● Serious: Vision loss, peripheral neuropathy, and psychiatric disturbances.
Pregnancy Category: Category C – Use only if the benefits outweigh the risks.
Common Brands
● Sabril