Short-term treatment of cocaine and/or methamphetamine abuse with vigabatrin: ocular safety pilot results.
OBJECTIVE
To evaluate the ocular safety of short-term use of vigabatrin to treat cocaine and/or methamphetamine addiction.


METHODS
Individuals who were actively using cocaine and/or methamphetamine were eligible for enrollment. Enrolled subjects were scheduled for comprehensive eye examinations at the beginning and end of the study. Visual field testing was performed at baseline and 1 week, 4 weeks, 8 weeks, and 1 month or more after discontinuing vigabatrin. Twenty-eight subjects received at least 1 dose of vigabatrin; however, only 20 subjects continued beyond the initial escalating vigabatrin dose phase to the treatment phase. Of these 20 subjects, 18 completed the study with full follow-up. Visual fields were evaluated subjectively by 2 glaucoma specialists and analyzed objectively for group and individual changes in quadrant mean sensitivity. The objective analysis was also repeated for superior field quadrants after excluding the uppermost peripheral points to minimize the eyelid effect. The main outcome measures were change of visual field, visual acuity, and ocular adverse effects.


RESULTS
Vigabatrin seemed to help treat cocaine and/or methamphetamine addiction. Of 18 subjects, 16 had negative test results for cocaine and methamphetamine use during the last 6 weeks of the trial. No ocular adverse events were detected. The subjective evaluation did not reveal visual field constriction in any of the 18 evaluable participants. Objective group and individual analyses for quadrant mean sensitivity did not show any change from baseline in any quadrant. No changes in visual acuity were noted.


CONCLUSIONS
In this short-term pilot study, vigabatrin seemed to help treat cocaine and/or methamphetamine abuse. There was no evidence of ocular or visual field adverse effects.
Fechtner
Robert D
RD
Institute of Ophthalmology and Visual Science, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 90 Bergen Street, Newark, NJ 07103, USA. Fechtner@umdnj.edu
Khouri
Albert S
AS
Figueroa
Emilia
E
Ramirez
Marina
M
Federico
Martha
M
Dewey
Stephen L
SL
Brodie
Jonathan D
JD
D000328:Adult; D019969:Amphetamine-Related Disorders / Q000188:drug therapy* / Q000503:physiopathology; D019970:Cocaine-Related Disorders / Q000188:drug therapy* / Q000503:physiopathology; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D018682:GABA Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D016896:Treatment Outcome; D020888:Vigabatrin / Q000009:adverse effects / Q000627:therapeutic use*; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects / Q000502:physiology
D004791:Enzyme Inhibitors; D018682:GABA Agents; D020888:Vigabatrin