How does Sabril (vigabatrin) treat infantile spasms?

Shaun A. Hussain, MD
Sabril, the brand name of vigabatrin, is believed to work for infantile spasms by inhibiting an enzyme that breaks down GABA (gamma-aminobutyric acid). GABA is the key inhibitory neurotransmitter, or messenger, in the brain. The idea is to stop it from getting broken down so there is more GABA hanging around in the brain, and that inhibits seizures. This is an oversimplication however.

Other drugs that work on the same system don't work for infantile spasms. Some of them may make infantile spasms worse. The hope is that this can be figured out a little bit better. There are a few similar drugs along the drug development pipeline that are coming to the forefront that might be even better than vigabatrin. The hope is that they are equally or more effective, but don't carry the same risk of vision loss and other side effects.
Sabril, or vigabatrin, increases the level of gamma amino butyric acid (GABA) in the brain to better balance brain chemicals. Low GABA levels are believed to be a cause of spasms. Sabril is typically prescribed to those in their late teens or older. The powder form is sometimes prescribed to infants suffering from infantile spasms. When given to infants, Sabril is not used with other medications. Use of Sabril is recommended only after signing a SHARE agreement recognizing the vision risks and agreeing to regular check ups to monitor vision and dose.

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