喜保宁(氨己烯酸片)是什么药？

(Vigabatrin tablets) are vinyl derivatives of γ-aminobutyric acid (GABA) and can be used as competitive inhibitors of GABA transaminase. Vigabatrin prevents the breakdown of GABA and therefore may increase GABAergic neuroinhibitory activity. Therefore, in 2009, the drug was approved by the U.S. Food and Drug Administration (FDA) and used to treat infantile spasms (IS).

About Vigabatrin (vigabatrin tablets)

Vigabatrin (vigabatrin) is an anti-epileptic drug developed by Mactan Lundbeck Pharmaceutical Company. It was approved by the US FDA in August 2009 for the treatment of epilepsy in infants and adults. Vigabatrin (GABA), as an inhibitor of transaminase, has irreversible inhibition of GABA transaminase and exerts a therapeutic effect by increasing the level of GABA in the brain. It is clinically used for the treatment of infantile spasms between one month and two years old. In addition, it is used as an auxiliary therapeutic drug for the treatment of refractory complex partial seizures in adults.

The role of Vigabatrin (vigabatrin tablets)

Vigabatrin is effective in treating infantile spasms, with a remission rate of up to 95%. Vigabatrin can exert anti-epileptic effects by increasing the inhibitory effect of GABA. In addition, it can also affect the mTOR pathway. This additional effect is significant in anti-epileptic treatment. As a second-line treatment option, adrenocorticotropic hormone can be used in combination with vigabatrin to achieve better therapeutic effects.

Vigabatrin (vigabatrin tablets) usage and dosage

1. Adults: The recommended dose is 3 grams per day, divided. The dose can be gradually increased according to clinical effects, by 0.5-1 g per day, with the highest dose being 4 g per day (or 50 mg/kg per day), which is effective for complex partial seizures of epilepsy (with or without generalized tonic-clonic seizures).

2. Children: The general usage is for children aged 3-9 years old. The recommended dose is 1 gram per day, taken in 2 times; for older children, 2 grams per day, taken in 2 times. For West syndrome, the average oral dose is 100 mg/kg daily (range 50-150 mg/kg).

Therapeutic effects of Vigabatrin (vigabatrin tablets)

Study purpose: To evaluate the efficacy and safety of vigabatrin in the treatment of infantile spasms.

Research method: 46 patients with infantile spasms who were diagnosed and treated at Severance Children's Hospital in South Korea from April 2015 to September 2016 were selected to be treated with oral vigabatrin. The starting dose was 50 mg/(kg·d) and increased to 100 mg/(kg·d) on the second day. If the symptoms were obviously controlled, the application was continued for 3 to 6 months and the electroencephalogram was reviewed regularly; if it was ineffective after 1 week, the dose was increased to 150 mg/(kg·d). , application is 3 to 6 months, and follow-up time is 3 to 10 months.

Research results: The total effective rate of vigabatrin monotherapy was 67.4% (31/46), the seizure-free rate was 19.6% (9/46), and the recurrence rate was 6.5% (3/46). The main short-term adverse reactions were lethargy, anorexia, irritability, and hyperactivity.

Research conclusion: Vigabatrin has a significant effect in treating infantile spasms, with a low recurrence rate and adverse reactions usually appear early.

Adverse reactions of Vigabatrin (vigabatrin tablets)

Adverse reactions of Vigabatrin (vigabatrin tablets) include but are not limited to the following:

1. Common adverse reactions include fatigue, drowsiness, headache, dizziness, confusion and depression.

2. Occasionally, aggressive behavior and psychotic symptoms may occur (mainly in patients with a history of mental illness and behavioral problems), memory loss, diplopia, weight gain, gastrointestinal disorders, edema and hair loss.

3. Nystagmus, nervousness, irritability, ataxia, paresthesia and tremor may also occur.

4. A very small number of patients may develop irreversible visual field defects, retinal lesions (such as peripheral retinal atrophy), and more rarely, optic neuritis and atrophy.

5. Mentally, agitation, aggressive behavior, and paranoia may occur, regardless of whether there is a history of mental illness.

6. A very small number of patients may develop mania or mental disorder.

7. Hemoglobin and transaminase values may decrease.

8. In children, excitement and anxiety may occur.

Summary

Vigabatrin (Sabril) is an effective anti-epileptic drug. It is a drug used to treat epilepsy and infantile spasms. It was developed in the 1980s and approved for treatment in the UK in 1989. It can be used as an auxiliary treatment for partial seizures in refractory complex epilepsy. The drug has good effects and is worthy of clinical promotion.

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