POMC and hypertensive disorder: There is also a high side effect burden associated with these medications; major side effects of ACTH include immunosuppression, hypertension, adrenal insufficiency, cardiomyopathy, gastrointestinal problems and electrolyte imbalances, while vigabatrin can lead to irreversible peripheral visual field defects and structural changes on brain MRI consistent with intramyelinic edema [6].