喜保宁和氯巴占哪个效果好？

Vigabatrin and clobazam are both anti-epileptic drugs. Both are effective. There is no clinical statement that which one is more effective. Patients can choose the drug treatment that suits them under the guidance of a doctor.

Treatment mechanism and efficacy

Vigabatrin is a structural analog of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), and its antiepileptic effects are produced by irreversibly inhibiting the degrading enzyme GABA transaminase, which increases GABA levels in the central nervous system (CNS). It is synthesized according to a specific targeting mechanism and subsequently shown to work through that mechanism.

Intractable epilepsy, such as infantile spasms (IS) and complex partial epilepsy (CPS), in addition to greatly increasing patients' risk of premature death, can have serious negative effects on patients' neurological integrity and quality of life. Early identification of potentially effective medical treatments is important, and Vibatrin has been shown to be a generally well-tolerated and effective antiepileptic drug (AED) for a variety of seizure types affecting children and adults, particularly those with IS and CPS.

In addition, Vigabatrin was evaluated in the treatment of infantile spasms (IS) and refractory complex partial epilepsy (CPS), showing that the spasms stopped after about 2 weeks of treatment and the response was rapid.

Curative effect

Clobazole is an anxiolytic agent that has been shown to be a broad-spectrum antiepileptic drug that is effective and well tolerated. It is mainly used as an auxiliary treatment for other anti-epileptic drugs without major side effects. It is also recommended as a monotherapy for partial and selective epilepsy in children.

Clobazole, like other benzodiazepines, has a long history of use in the treatment of epilepsy. Recently, it was approved in the United States as adjunctive therapy for the treatment of seizures associated with lenox-gastaut syndrome in patients aged ≥2 years.

In a pivotal placebo-controlled trial in pediatric and adult patients with Lennox-Gastaut syndrome (n = 217 evaluable), adjuvant treatment with clobazole 5 to 40 mg/day for 12 weeks significantly reduced mean weekly reductions in seizure rates from baseline compared with adjuvant placebo (primary endpoint), with a significant dose-dependent improvement in these rates.

Results from a dose-ranging, double-blind, multicenter, phase II trial further support the efficacy of clobazole in pediatric and adult patients with lenox-gastaut syndrome (n = 61 evaluable). In an ongoing open-label extension study, the improvements in mean weekly seizure rate reduction with adjuvant clobazole therapy were maintained in these short-term trials, with a 91.6% reduction in mean weekly seizure rate reduction in the overall population from baseline (initial trial randomization) to 24 months.

References

1. Wheless JW, Ramsay RE, Collins SD. Vigabatrin. Neurotherapeutics. 2007 Jan;4(1):163-72. doi: 10.1016/j.nurt.2006.11.008. PMID: 17199033; PMCID: PMC7479688.

2. Yang LP, Scott LJ. Clobazam: in patients with Lennox-Gastaut syndrome. CNS Drugs. 2012 Nov;26(11):983-91. doi: 10.1007/s40263-012-0007-0. PMID: 23034582.