Adrenocorticotropin (adrenocorticotropic hormone or ACTH) is one of two treatments considered to be first-line therapy for
infantile spasms (the other is vigabatrin). It may also be used in treatment of various other childhood seizures when other
treatments have failed.
ACTH may be very effective in controlling seizures, but its use is restricted by long-term side effects. This medication is
given only by injection, so this also complicates its use.
Brand names
Course of treatment
In the treatment of infantile spasms, ACTH is used on a short-term basis because a seizure-free state is often sustainable
even after the drug has been stopped.
ACTH is given by injection, either at a hospital, in the doctor's office, or at home. If it is given at home, a member of
the epilepsy care team will show you how to inject it. Your child may need to have one or more injections per day. Treatment
for infantile spasms usually lasts for two to six weeks. Because this medication is a steroid, it needs to be slowly weaned
to avoid withdrawal side effects, so the total length of treatment may be longer.
Side effects
ACTH is a steroid medication and has all the side effects of this group of drugs. Serious possible side effects include suppression
of the immune system resulting in dangerous infections. Other side effects, which can usually be managed during treatment,
include high blood pressure, diabetes, weight gain, and irritability. As with any injected medication, there is a risk of
skin reaction at the site of injection. Cerebral atrophy or reduction in brain size has occurred in children treated with
ACTH; however, this is most often reversible and not associated with changes in the child. ACTH can also suppress adrenal
function, but this can usually be reversed once therapy is over.
Routine monitoring of blood, urine, and blood pressure by your child's doctor will be necessary. For more information on monitoring,
please see the "Drug Monitoring" page in this section.
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