Vigabatrin use in psychotic epileptic patients: Report of a prospective pilot study

Objectives - Evaluation of any possible behavioural reactions in epileptic patients during vigabatrin treatment. Material and methods - Ten patients with refractory partial epilepsy, previous mental retardation and psychosis or other significant psychiatric morbidity treated with vigabatrin were submitted periodically to specific tests (to quantify any possible change in behavioural parameters) and also to EEG recordings. Results - After 1 year of treatment 5/10 patients became seizure-free, 3/10 of them presented reduction of seizures by over 75%. None of the subjects presented episodes that could be interpreted as psychotic reactions and, moreover, some patients showed a reduction in stereotypies, instability and aggressiveness. In 66% of these patients an improvement in cognitive functions was observed. Conclusion - The onset of side effects can be prevented by a gradual introduction of vigabatrin and by the use of the drug in moderate doses. These data do not confirm the contraindication to treat with vigabatrin patients with a history of psychiatric disturbances.