An anti-epileptic medicine
Vigabatrin
An anti-epileptic used for infantile spasms and resistant focal epilepsy, with a serious risk of permanent vision loss.
What is Vigabatrin?
Vigabatrin is an anti-epileptic medicine used for infantile spasms (a seizure type in babies) and for focal seizures that have not responded to other treatments. Its most important risk is that it can permanently damage side (peripheral) vision in a large proportion of people who take it, and this damage does not recover. Because of this, it is started and supervised by specialists and regular eye-field tests are needed. It is used only when its benefits are judged to outweigh this serious risk, and it should never be stopped suddenly.
Education and reference only. This is a plain-language guide to Vigabatrin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Vigabatrin is a medicine that reduces seizure activity in the brain. It is reserved for specific, difficult situations: infantile spasms in babies and focal (partial) seizures that have not been controlled by other anti-epileptics, usually added to existing treatment. It is a specialist medicine because of a serious effect on eyesight, so it is started, monitored and reviewed under expert care. It is taken regularly every day.
How it works
Vigabatrin raises the level of a calming brain chemical called GABA by blocking the enzyme that normally breaks it down. More GABA dampens the over-activity that drives seizures, helping to control infantile spasms and resistant focal seizures. Unfortunately the same widespread effect is linked to gradual, often permanent loss of peripheral (side) vision, which is why its use is so carefully controlled.
Company & origin
Originated / developed by: Generic (originally Sanofi).
An anti-epileptic used in the UK for infantile spasms and for hard-to-control focal seizures, prescribed under specialist care because of a serious risk to eyesight.
What it treats
Conditions Vigabatrin is used for
Practical use
How to take Vigabatrin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it every day as prescribed by the specialist team, without stopping suddenly.
- Attend all eye (visual field) tests, as serious sight loss can develop without you noticing.
- Report any change in your vision, especially side vision, to your team straight away.
- Give the liquid or granules exactly as instructed, measuring carefully, particularly for babies and children.
- Tell your prescriber about drowsiness, mood changes or unusual behaviour.
- If a dose is missed, follow the advice you were given rather than doubling up.
Weighing it up
Advantages & disadvantages of Vigabatrin
Advantages
- Can control infantile spasms, a serious seizure type in babies, where it is an important option.
- May help focal seizures that have not responded to other anti-epileptics.
- Available in forms suitable for babies and young children under specialist care.
Disadvantages
- Carries a serious risk of permanent loss of side vision that does not recover.
- Requires regular specialist eye-field testing throughout treatment.
- Can cause drowsiness, weight gain and mood or behaviour changes.
Practical use
Good to know
The single most important thing to understand about vigabatrin is that it can cause permanent loss of side vision, which can develop without obvious symptoms and does not get better even after stopping. Because of this, eyesight (visual field) testing is arranged before treatment and at regular intervals, and any vision change must be reported at once. The decision to use it weighs this serious risk against the benefit, which is why it is specialist-only. Like other anti-epileptics it must not be stopped suddenly, can cause drowsiness and mood changes, and you should report new low mood or thoughts of self-harm. Babies on it for infantile spasms are watched especially closely.
Who should not take it / use with caution
- People with existing significant visual field loss should generally not take it.
- It is avoided where reliable eye-field monitoring cannot be carried out, unless benefits clearly outweigh the risk.
- It is used with great caution in those with a history of serious mood problems.
Monitoring
- Regular visual field (eyesight) testing before and during treatment to detect sight loss early.
- Reviewing seizure control alongside the risk to vision at each appointment.
- Watching for drowsiness, mood or behaviour changes, especially in children.
Side effects
- Permanent narrowing of side vision is the most serious effect and can occur without symptoms.
- Drowsiness, dizziness, tiredness, weight gain and headache are common.
- Mood changes, irritability or behaviour changes, which should be reported.
Key interactions
- Other anti-epileptic medicines may need adjusting, as vigabatrin can affect seizure control.
- Medicines that cause drowsiness, including alcohol, can add to its sedating effect.
- Tell your prescriber about all medicines, as changes can alter how well seizures are controlled.
Available as: Tablets and oral powder (sachets) to be dissolved, taken by mouth.
Answers
Vigabatrin: frequently asked questions
Why does vigabatrin need eye tests?
It can cause permanent loss of side vision, which may develop without symptoms, so visual field tests are done before and regularly during treatment to catch any change early.
Can the vision damage get better if I stop?
No. The loss of peripheral vision is usually permanent and does not recover even after stopping, which is why the risk is taken so seriously.
Why is it only started by a specialist?
Because of the serious sight risk and the conditions it treats, it is started, monitored and reviewed under expert care to weigh benefit against risk.
Is it used in babies?
Yes, it is an important option for infantile spasms in babies, who are monitored especially closely while taking it.
Can I stop it suddenly?
No. Like other anti-epileptics it must not be stopped abruptly, as this can trigger seizures; any change is made gradually under your team's guidance.
Authoritative sources
- BNF
- NICE CKS
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