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 .
Side effects of phenobarbital in toddlers; behavioral and cognitive aspects.
Cognitive and behavioral effects of phenobarbital in toddlers were assessed in a r and omized , placebo-controlled study of patients who had had a febrile seizure . There were no significant differences in IQ ( Binet or Bayley Scales ) between placebo and phenobarbital groups after eight to 12 months of therapy . However , detrimental effects of phenobarbital were found in memory , for which serum level influenced scores , and in comprehension , in that length of treatment time affected performance . Hyperactivity was not seen . Behavioral changes , reported by parents , were increased fussiness and a characteristic disturbance of sleep . These changes varied in severity and were classified as transient , dose related , or unacceptable . After 12 months in the study , most parents could not distinguish between phenobarbital and placebo . Our data suggest that although most toddlers do not have major side effects from phenobarbital therapy when treated for a year , serum levels and length of time on phenobarbital should be kept at a minimum to reduce negative cognitive and behavioral effects
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 .