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Published on: May 16, 2019
Vigabatrin versus carbamazepine monotherapy for epilepsy
Yousheng Xiao1, Lu Gan, Jin Wang
1Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning, Guangxi, China, 530021.
Vigabatrin (VGB) monotherapy for epilepsy showed no significant difference from carbamazepine (CBZ) in treatment withdrawal or remission, but increased seizure frequency. VGB was linked to weight gain but fewer rashes and less drowsiness.
Area of Science:
- Neurology
- Pharmacology
Background:
- Efficacy and safety of vigabatrin (VGB) as add-on therapy for refractory epilepsy are established.
- Risk of visual field defects with VGB necessitates careful consideration.
- Systematic review on VGB versus carbamazepine (CBZ) monotherapy for epilepsy is lacking.
Purpose of the Study:
- To compare the efficacy and safety of VGB versus CBZ monotherapy for epilepsy in children and adults.
Main Methods:
- Searched multiple databases (CENTRAL, MEDLINE, EMBASE, CBM) up to July 2015.
- Included randomized controlled trials (RCTs) comparing VGB and CBZ monotherapy for epilepsy.
- Assessed time to treatment withdrawal, remission, seizure occurrence, and adverse events.
Main Results:
- Five studies with 734 participants were included; one good quality, four poor quality.
- No significant differences in treatment withdrawal or six-month remission between VGB and CBZ.
- VGB showed a disadvantage in time to first seizure and was associated with more weight gain but fewer rashes and less drowsiness.
Conclusions:
- Insufficient data to establish the risk-benefit balance of VGB versus CBZ monotherapy for epilepsy.
- VGB monotherapy should be used cautiously for epilepsy due to visual field defect risks.
- Future research should investigate visual field defects and improve monotherapy study methodologies.
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