Antiepileptic efficacy of vigabatrin in people with severe epilepsy and intellectual disability.
Vigabatrin added to usual seizure drugs gives adults with ID a fair shot at fewer seizures for years without harming cognition.
01Research in Context
What this study did
Doctors added vigabatrin to the seizure drugs adults with ID already took.
They watched seizure counts for six years to see if the extra pill helped.
The team also checked if thinking skills dropped after long-term use.
What they found
Four out of ten adults had half as many seizures after three months.
Two out of ten still had that benefit six years later.
Most people had no mood or behavior side effects.
How this fits with other research
Ellingsen et al. (2014) warn that adults with ID plus epilepsy die from sudden seizure death far more often than other adults. Seizure control, not just counting pills, matters.
S-Johnson et al. (2009) show that problem behaviors in the same population can improve on their own. This reminds us to keep watching behavior even when we add a new drug.
Smith et al. (1997) tested a different add-on pill for mood in younger people with ID. Both studies found extra medicine can help without hurting thinking skills.
Why it matters
If you serve adults with ID who still seize despite meds, vigabatrin is a low-risk add-on that may cut seizures in half. Track seizure counts monthly and teach caregivers the signs of emergency so the gains shown here turn into real-world safety.
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02At a glance
03Original abstract
The short- and long-term clinical efficacy of add-on vigabatrin treatment was evaluated in a group of 36 patients with intellectual disability and drug-refractory epilepsy. The results were compared to the efficacy of vigabatrin in 75 non-retarded patients with drug-resistant complex partial and secondarily generalized seizures. After 3 months, 42% of the patients with intellectual disability had experienced a reduction in seizure frequency of more than 50% (responders). The percentage of responders was still 22% after 6 years. No impairment in psychological function was observed during vigabatrin treatment compared with baseline values. However, one patient was excluded from long-term treatment because of psychotic depression and two patients because of psychomotor slowing after 1-2 years of treatment The need for extra supervision appeared to diminish and three patients were able to be discharged from institutional care during the follow-up. In the group of non-retarded patients, the percentages of the responders were 55% and 27% after 3 months and 6 years of treatment, respectively. The results from these studies suggest that vigabatrin is effective and relatively well tolerated, and that the successful treatment of epilepsy also has socio-economic consequences in patients with intellectual disability and severe epilepsy.
Journal of intellectual disability research : JIDR, 1998 · doi:n/a