In the last 30 years there has been a renewal in the pharmacology of epilepsy seeking to improve the effectiveness and reduce the adverse effects of this type of medication.
Among the drugs that have emerged is vigabatrin, which increases the concentration of GABA and decreases the appearance of epileptic seizures.
The epilepsy affects 1% of the population, around 50 million people Worldwide. In most cases there is no obvious cause although it may appear as a result of trauma, tumors or infections.
What is epilepsy?
The epilepsy is a very frequent pathology characterized by the succession of crises due to uncoordinated neuronal discharges. For the brain to perform its actions correctly, it needs an orderly discharge of electrical impulses. When this does not occur seizures appear.
As for the types of epilepsy that exist, we can to differentiate roughly between partial and generalized crises.
Mechanisms of action of antiepileptic drugs
Drugs that are used for the treatment of epilepsy and seizures are popularly known as antiepileptics or anticonvulsants . It is shown that with an adequate pharmacological treatment can be controlled up to 75% of the patients, being a disease that greatly alters the quality of life.
In general, treatments for epilepsy are often composed of several types of drugs. At the same time, its continued administration is usually necessary for years. This is why special attention should be paid to the adverse reactions of this type of medication.
Antiepileptic drugs that exist in the market they can act through one of the following mechanisms. It is important to emphasize that the same drug can fulfill several of these functions:
- Decrease in the propagation of neuronal impulses . This action occurs by blocking the sodium channels of the neurons.
- Empowerment of GABA action . GABA is an inhibitory mediator, so that its potentiation decreases neuronal activity. This can be achieved by inhibiting some enzymes such as GABA-T or by reducing reuptake.
Vigabatrin in the treatment of epilepsy
Vigabatrin is an antiepileptic drug that exerts its function through the irreversible inhibition of the GABA-T enzyme (GABA transaminase)
This enzyme intervenes in the degradation of GABA so the inhibition of it will increase its concentration. The increase in GABA will inhibit the propagation of impulses by neurons, thus managing epileptic seizures.
Vigabatrin is part of the treatment in patients with partial epilepsy resistant to other medications. Likewise, It is also used in the treatment of infantile spasms ( West syndrome ).
This drug it is contraindicated in cases of hypersensitivity, as well as during pregnancy and lactation. It must be administered with care because it interacts easily with other anticonvulsants such as phenobarbital, phenytoin or primidone.
However, despite the fact that vigabatrin has a simple dosage regimen have other problems Some of the adverse reactions that can precipitate are alterations of the irreversible visual field, depression or hallucinations.