The perspective of GABA replenishment therapy in the epilepsies: A critical evaluation of hopes and concerns

Impaired GABA-mediated inhibition is probably one of the cellular abnormalities leading to Focal Epilepsy. The role of GABA in generalized seizures, particularly of Petit Mal type, is unknown. Various approaches are available to potentiate GABA function. Merits and flaws of each one of them are critically evaluated. In some forms of epilepsy, GABA agonists may replenish depleted pools, and in some others may nonspecifically raise the general excitability threshold of the brain, yet in other forms they may exert a glutamate/aspartate antagonistic effect. The available experimental evidence suggests that in bilaterally synchronous spike and wave epilepsies, GABA agonists are either ineffective or pejorative.