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 .
Comprehensive primary health care antiepileptic drug treatment programme in rural and semi-urban Kenya
A programme of antiepileptic treatment in a rural and semi-urban region in Kenya was assessed . Patients with generalised tonic-clonic seizures were treated according to one of two simple drug protocol s. Health workers screened cases reported by key informants in the community . From the 529 patients identified by health workers as having active seizures 302 patients aged 6 - 65 years were recruited by a psychiatrist for therapy with carbamazepine or phenobarbitone . Treatment was supervised largely by primary health workers , and the programme was monitored by a research team , which assessed the effectiveness of treatment . Of the 249 patients who completed the study , 53 % became seizure-free in the second 6 months of therapy , and another 26 % had substantially ( 50 % or more reduction ) fewer seizures than in the 6 months before therapy . The similarity of these findings to those obtained in newly diagnosed patients in the developed world , the low drop-out rate , the low rate of withdrawal due to adverse effects , and the acceptable compliance with therapy indicate that health workers can monitor therapy adequately . Most patients had had several years of delay before starting therapy for their epilepsy , yet they responded well -- a finding that does not support the suggestion that the disorder becomes intractable if not treated early
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 .