Vigabatrin.
Vigabatrin (VGB) is a structural analogue of the inhibitory neurotransmitter gamma-amino butyric acid (GABA), which produces its antiepileptic effect by irreversibly inhibiting the degradative enzyme GABA-transaminase. This produces an increase in central nervous system (CNS) GABA levels. VGB is among the few antiepileptic drugs (AEDs) that was synthesized with a specific targeted mechanism in mind and was subsequently demonstrated to function by that mechanism. Tiagabine, a GABA reuptake blocker, is the only other "designer drug" among the currently available AEDs. Therefore, VGB is among the few AEDs for which the mechanism of action is well understood. Recently, safety issues have been raised with regard to the use of vigabatrin. This article reviews the mechanism of action, pharmacokinetics, safety, and efficacy of VGB.
French
J A
JA
Department of Neurology, University of Pennsylvania, Philadelphia 19104, USA.
D000612:4-Aminobutyrate Transaminase / Q000037:antagonists & inhibitors; D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001923:Brain Chemistry / Q000187:drug effects; D002986:Clinical Trials as Topic; D003071:Cognition / Q000187:drug effects; D003866:Depressive Disorder / Q000139:chemically induced; D015198:Designer Drugs / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D009483:Neuropsychological Tests; D018079:Receptors, GABA / Q000187:drug effects; D013036:Spasms, Infantile / Q000188:drug therapy / Q000378:metabolism; D016896:Treatment Outcome; D020888:Vigabatrin / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D005680:gamma-Aminobutyric Acid / Q000378:metabolism
D000927:Anticonvulsants; D015198:Designer Drugs; D018079:Receptors, GABA; D005680:gamma-Aminobutyric Acid; D000612:4-Aminobutyrate Transaminase; D020888:Vigabatrin