Comparative Pharmacology
Head-to-head clinical analysis: DEPAKOTE versus VIGABATRIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEPAKOTE versus VIGABATRIN.
DEPAKOTE vs VIGABATRIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Increases GABA levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase; also blocks voltage-gated sodium channels and T-type calcium channels.
Irreversibly inhibits GABA transaminase, increasing brain GABA levels.
Initial dose 750 mg/day PO in divided doses; increase by 250-500 mg/day every 3-7 days; maintenance dose 1000-2000 mg/day PO divided BID or TID; maximum 60 mg/kg/day.
Adults: 500 mg orally twice daily; may increase by 500 mg/day every 7 days up to 1500 mg twice daily. For refractory complex partial seizures, maximum 3000 mg/day.
None Documented
None Documented
Terminal: 9-16 hours (mean 12 h); extended with hepatic dysfunction, co-administered enzyme inhibitors, or in elderly.
Clinical Note
moderateVigabatrin + Venlafaxine
"The risk or severity of adverse effects can be increased when Vigabatrin is combined with Venlafaxine."
Clinical Note
moderateVigabatrin + Nefazodone
"The risk or severity of adverse effects can be increased when Vigabatrin is combined with Nefazodone."
Clinical Note
moderateVigabatrin + Stiripentol
"The risk or severity of adverse effects can be increased when Vigabatrin is combined with Stiripentol."
Clinical Note
moderateVigabatrin + Clomipramine
5-8 hours in young adults; 12-17 hours in elderly; prolonged with renal impairment.
Renal: <3% as unchanged drug; >95% as metabolites (glucuronide conjugates, oxidation products). Biliary/fecal: minor, <5%.
Renal: ~80% unchanged in urine; fecal: <5%.
Category C
Category A/B
Anticonvulsant
Anticonvulsant
"The risk or severity of adverse effects can be increased when Vigabatrin is combined with Clomipramine."