Skip to main content
SpringerLink
Log in

Anti-convulsant Agents: Vigabatrin

  • Reference work entry
  • First Online:
NeuroPsychopharmacotherapy

  • 62 Accesses

Abstract

Vigabatrin (VGB) is a structural analog of gamma-aminobutyric acid (GABA), which increases the GABA concentration in brain by blocking its degradation. The antiepileptic effect is based on the inhibition of neuronal hyperexcitability.

VGB is a first-line drug in controlling infantile spasms, especially in patients with tuberous sclerosis complex. The efficacy on focal seizures is similar to first-line antiepileptic drug like carbamazepine; side effects are comparable. High rates of irreversible visual field loss are the main restriction in the use of VGB. High doses, prolonged exposure and increasing age are identified to be the main risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 949.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,399.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Appleton RE, Peters ACB, Mumford JP, Shaw DE. Randomized, placebo-controlled study of Vigabatrin as first-line treatment of infantile spasms. Epileysia. 1999;40(1 1):1627–33.

    Article  CAS  Google Scholar 

  • Ben-Menachem E, Sander JW. Vigabatrin therapy for refractory complex partial seizures: review of major European trials. Acta Neurol Scand. 2011;124(Suppl.192):16–28.

    Article  Google Scholar 

  • Chiron C, Dumas C, Jambaque I, Mumford J, Dulac O. Randomized trial comparing vigabatrin and hydrocortisone in infantile spasms due to tuberous sclerosis. Epilepsy Res. 1997;26:389–95.

    Article  CAS  PubMed  Google Scholar 

  • Darke K, Edwards SW, Hancock E, Johnson AL, Kennedy CR, Lux AL, Newton RW, O’Callaghan FJ, Verity CM, Osborne JP. Developmental and epilepsy outcomes at age 4 years in the UKISS trial comparing hormonal treatments to vigabatrin for infantile spasms: a multi-centre randomised trial. Arch Dis Child. 2010;95(5):382–6.

    Google Scholar 

  • Elterman RD, Shields WD, Bittman RM, Torri SA, Sagar SM, Collins SD. Vigabatrin for the treatment of infantile spasms: final report of a randomized trial. J Child Neurol. 2010;25(11):1340–7.

    Article  PubMed  Google Scholar 

  • Hemming K, Maguire MJ, Hutton JL, Marson AG. Vigabatrin for refractory partial epilepsy (Review). Cochrane Database Syst Rev. 2013; issue 1.Art.No.:CD007302

  • Hussain SA, Tsao J, Li M, Schwarz MD, Zhou R, Wu JY, Salamon N, Sankar R. Risk of vigabatrin-associated brain abnormalities on MRI in the treatment of infantile spasms is dose-dependent. Epilepsia. 2017;58(4):674–82.

    Article  CAS  PubMed  Google Scholar 

  • LactMed: Drugs and lactation database. Vigabatrin. Updated 2018 Dec. 3.LactMed record number 1003.

    Google Scholar 

  • Lux AL, Edwards SW, Hancock E, Johnson AL, Kennedy CR, Newton RW, O’Callaghan FJ, Verity CM, Osborne JP. United Kingdom infantile spasms study. Lancet Neurol. 2005;4(11):712–7.

    Google Scholar 

  • Maguire MJ, Hemming K, Wild JM, Hutton JL, Marson AG. Prevalence of visual field loss following exposure to vigabatrin therapy: a systematic review. Epilepsia. 2010;51(12):2423–31.

    Article  PubMed  Google Scholar 

  • Nielsen JC, Hutmacher MM, Wesche DL, Tolbert D, Patel M, Kowalski KG. Population dose-response analysis of daily seizure count following Vigabatrin therapy in adult and pediatric patients with refractory complex partial seizures. J Clin Pharmacol. 2014;55(1):81–92.

    Google Scholar 

  • O’Callaghan FJK, Edwards SW, Dietrich Alber F, Hancock E, Johnson AL, Kennedy CR, Likeman M, Lux AL, Mackay M, Mallick AA, Newton RW, Nolan M, Pressler R, Rating D, Schmitt B, Verity CM, Osborne JP. Safety and effectiveness of hormonal treatment versus hormonal treatment with vigabatrin for infantile spasms (ICISS): a randomised, multicentre, open-label trial. Lancet Neurol. 2017;16:33–42.

    Article  PubMed  Google Scholar 

  • Ohtsuka Y. Efficacy and safety of vigabatrin in Japanese patients with infantile spasms: primary short-term study and extension study. Epilepsy & Behavior. 2018;78:134–41.

    Google Scholar 

  • Plant GT, Sergott RC. Understanding and interpreting vision safety issues with vigabatrin therapy. Acta Neurol Scand. 2011;124(Suppl 192):57–71.

    Article  Google Scholar 

  • Riikonen R, Rener-Primec Z, Carmant L, Dorofeeva M, Hollody K, Szabo I, Krajnc BS, Wohlrab G, Sorri I. Does vigabatrin treatment for infantile spasms cause visual field defects? An international multicentre study. Develop Med Child Neurol. 2015;57:60–7.

    Google Scholar 

  • Slater J, Chung S, Huynh L, Sheng Duh M, Gorin B, McMicken C, Ziemann A, Isojarvi J. Efficacy of antiepileptic drugs in the adjunctive treatment of refractory partial-onset seizures: meta-analysis of pivotal trials. Epilepsy Res. 2018;143:120–9.

    Article  CAS  PubMed  Google Scholar 

  • Spelbrink EM, Mabud TS, Reimer R, Porter BE. Plasma taurine levels are not affected by vigabatrin in pediatric patients. Epilepsia. 2016;57(8):e168–e72.

    Article  CAS  PubMed  Google Scholar 

  • Vigevano F, Cilio MR. Vigabatrin versus spasms: ACTH as first-line treatment for infantile: a randomized. Prospective Study Epilepsia. 1997;38(12):1270–4.

    Article  CAS  PubMed  Google Scholar 

  • Walker SD, Kälviäinen R. Non-vision adverse events with vigabatrin therapy. Acta Neurol Scand. 2011;124(Suppl.192):72–82.

    Article  Google Scholar 

  • Wild JM, Fone DL, Aljarudi S, Lawthom C, Smith PEM, Newcombe RG, Lewis GD. Modelling the risk of visual field loss arising from long-term exposure to the antiepileptic drug Vigabatrin: a cross-sectional approach. CNS Drugs. 2013;27:841–9.

    Article  CAS  PubMed  Google Scholar 

  • Xiao Y, Gan L, Wang J, Luo M, Luo H. Vigabatrin versus carbamazepine monotherapy for epilepsy. Cochrane Database Syst Rev. 2015;11:CD008781.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Epilepsy/Neuropediatrics, Berlin, Germany

    Axel Panzer

Authors
  1. Axel Panzer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Axel Panzer .

Editor information

Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

Section Editor information

  1. Beta Neurology – Competence Center for Epilepsy, Beta Klinik GmbH, Bonn, Germany

    Christian E. Elger

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Panzer, A. (2022). Anti-convulsant Agents: Vigabatrin. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_278

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-62059-2_278

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-62058-5

  • Online ISBN: 978-3-030-62059-2

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation