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Sabril
Diagnosis & Treatment > Seizure Medications > Sabril > How well does Sabril work?
 

How well does Sabril work?

Sabril (vigabatrin), although not officially approved in the United States because of concerns about vision problems, is useful in controlling partial seizures and some other specific seizure types. Many randomized controlled studies in both Europe and the United States have confirmed this effectiveness, which appears to continue for most patients during long-term treatment.

Studies of children with partial epilepsy have had results similar to the studies of adults.

In one American study, various doses of Sabril were given as add-on therapy to 174 people who had complex partial seizures (with or without secondary generalization) that were not well controlled by other seizure medicines. About half of the people who took 3 grams or more of Sabril per day had at least 50% fewer seizures.

A similar study using 3 grams per day of Sabril reported that 43% of patients had at least a 50% reduction in seizure frequency, compared to 19% of those who took a placebo in addition to their other medication. There were few problems with side effects.

A few studies have compared Sabril with carbamazepine (Tegretol or Carbatrol) used alone to treat patients with newly diagnosed partial seizures. Most have concluded that carbamazepine is more effective for this purpose but fewer patients from the Sabril group drop out because of side effects.

Sabril also may be effective in treating infantile spasms, especially those related to cerebral malformations or tuberous sclerosis, with fewer side effects than other treatments such as ACTH.

Sabril appears to be ineffective in controlling primary generalized seizures, including absence seizures and myoclonic seizures. Most studies have had poor results using it for Lennox-Gastaut syndrome, especially if myoclonic seizures are prominent.

Here are links to summaries of some of the studies discussed here:

Dean C, Mosier M, Penry K. Dose-response study of vigabatrin as add-on therapy in patients with uncontrolled complex partial seizures. Epilepsia. 1999;40(1):74-82. PMID: 9924905.

French JA, Mosier M, Walker S, et al. A double-blind, placebo-controlled study of vigabatrin (3 g/day) in patients with uncontrolled complex partial seizures. Vigabatrin Protocol 024 Investigative Cohort. Neurology 1996;46(1):54-61. PMID: 8559421.

Reviewed February 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.