cosyntropin + vigabatrin

Cosyntropin + vigabatrin is a combination therapy used primarily in the treatment of infantile spasms (West syndrome), a severe form of epileptic encephalopathy in infants. Cosyntropin is a synthetic form of adrenocorticotropic hormone (ACTH) that stimulates the adrenal cortex to produce corticosteroids, exerting anti-inflammatory and immunomodulatory effects. Vigabatrin is an antiepileptic agent that irreversibly inhibits gamma-aminobutyric acid transaminase (GABA-T), leading to increased levels of GABA, the main inhibitory neurotransmitter in the central nervous system. The combination has been studied for its efficacy compared to monotherapy with either agent; some studies suggest improved short-term spasm control with cosyntropin alone, while others indicate potential benefits from combination therapy over hormonal therapy alone for certain outcomes[1][2][4]. Both drugs are associated with significant adverse event profiles.