There is no evidence for a difference in antiepileptic efficacy between phenobarbital and any other compared AED , yet no evidence for absolute efficacy .
No convincing evidence exists for an excess of behavioural adverse effects , over other AEDs , attributable to phenobarbital .
Masked studies of phenobarbital in childhood epilepsy have shown no significant differences in behavioural or cognitive adverse effects compared to other AEDs .
This is in contrast to the excess of such adverse effects reported in studies open to observer bias .
However , the one finding of reduction in cognitive ability associated with phenobarbital treatment for febrile convulsions remains a concern .
INTRODUCTION : Against a background of concern about the safety of new pharmaceutical products , there has been renewed interest in one of the oldest antiepileptic drugs ( AEDs ) , phenobarbital .
Although still in widespread use in developing countries , its popularity has slipped in Western countries over the past century , partly because of controversy about its adverse effect profile .
This critical review examines the evidence supporting its effectiveness and its associated behavioural adverse effects for febrile convulsions and childhood epilepsy .
Phenobarbital for febrile seizures--effects on intelligence and on seizure recurrence.
Phenobarbital is widely used in the treatment of children with febrile seizures , although there is concern about possible behavioral and cognitive side effects . In 217 children between 8 and 36 months of age who had had at least one febrile seizure and were at heightened risk of further seizures , we compared the intelligence quotients ( IQs ) of a group r and omly assigned to daily doses of phenobarbital ( 4 to 5 mg per kilogram of body weight per day ) with the IQs of a group r and omly assigned to placebo . After two years , the mean IQ was 7.03 [ corrected ] points lower in the group assigned to phenobarbital than in the placebo group ( 95 percent confidence interval , -11.52 to -2.5 , P = 0.0068 [ corrected ] ) . Six months later , after the medication had been tapered and discontinued , the mean IQ was 5.2 points lower in the group assigned to phenobarbital ( 95 percent confidence interval , -10.5 to 0.04 , P = 0.052 ) . The proportion of children remaining free of subsequent seizures did not differ significantly between the treatment groups . We conclude that phenobarbital depresses cognitive performance in children treated for febrile seizures and that this disadvantage , which may outlast the administration of the drug by several months , is not offset by the benefit of seizure prevention
There is no evidence for a difference in antiepileptic efficacy between phenobarbital and any other compared AED , yet no evidence for absolute efficacy .
No convincing evidence exists for an excess of behavioural adverse effects , over other AEDs , attributable to phenobarbital .
Masked studies of phenobarbital in childhood epilepsy have shown no significant differences in behavioural or cognitive adverse effects compared to other AEDs .
This is in contrast to the excess of such adverse effects reported in studies open to observer bias .
However , the one finding of reduction in cognitive ability associated with phenobarbital treatment for febrile convulsions remains a concern .
INTRODUCTION : Against a background of concern about the safety of new pharmaceutical products , there has been renewed interest in one of the oldest antiepileptic drugs ( AEDs ) , phenobarbital .
Although still in widespread use in developing countries , its popularity has slipped in Western countries over the past century , partly because of controversy about its adverse effect profile .
This critical review examines the evidence supporting its effectiveness and its associated behavioural adverse effects for febrile convulsions and childhood epilepsy .