Epilepsy drug requires monitoring

Dear Dr. Roach: I have been taking Sabril for five years. I have drug-resistant epilepsy, and this is the first drug that has worked. It is a high-risk medication, as it can affect eyesight. I have my eyes checked every three months.

Is this safe to keep taking, or should it be only taken for a short time? — C.N.

Many people equate seizures and epilepsy. There is more than one kind of seizure, and only a person with recurrent seizures can be said to have epilepsy. Seizures from fever in children are not necessarily epilepsy. Epilepsy is best taken care of by a neurologist.

As opposed to a generalized seizure, where the whole brain becomes involved, the drug you’re taking is used for drugresistant focal epilepsy. “Focal” means that one particular part of the brain is affected. Focal seizures may cause motor symptoms, such as uncontrollable movement of one part of the body; sensory symptoms, such as abnormal taste or odor sensation; autonomic findings, such as bladder, bowel or blood pressure changes; or central nervous symptoms, which may cause symptoms of fear, anxiety or deja vu. Complex focal seizures are often characterized by staring into space, but may also consist of a nonpurposeful repetitive movement, such as lip smacking.

Sabril (vigabatrin) is used when other medicines have failed. As many as 30% to 50% of people who are on this medicine for five years will develop vision problems, which may not be noticed by the person taking the medicine. This is why frequent vision tests are mandatory.

As long as the medicine is working and not causing any side effects, and the vision tests show good results, the medication is safe to keep taking. You must continue to get the vision tests (especially testing the visual field) as long as you take the medicine, and stop if any vision problems develop.