Non-steroidal anti-inflammatory drugs and peptic ulcers.

Abstract

Long term follow up studies for one to four years have not shown any tolerance to the efficacy of the drug or any long term side effects (E H Reynolds et al, 18th epilepsy international congress, New Delhi, 1989).21-23Vigilance for possible long term toxicity should continue because early studies of toxicity in rats and dogs showed that microvacuoles suggestive of intramyelinic oedema were reversibly formed in the white matter in a dose related manner.2425In dogs microvacuolation was accompanied by changes in the transmission time through the central nervous system of somatosensory evoked potentials, but such changes have not been observed in patients receiving long term treatment.2627No evidence of intramyelinic oedema has been seen in six necropsies and 23 biopsy specimens taken from patients treated with vigabatrin for a mean of 25 months (D Scholey et al, Merrell Dow files, personal communication).The clinical evaluation of vigabatrin has proceeded cautiously, and the drug will be available only for treating epilepsy that is not satisfactorily controlled by other anti- epileptic drugs.Nevertheless, it may prove to be a milestone in the treatment of epilepsy not only because it is the first new antiepileptic drug since the licensing of sodium valproate in 1973 but also because it is the first successful rational approach to the treatment of chronic epilepsy.