Thus, when this drug is used, liver function should be closely monitored. Intermittent Therapy During Febrile Episodes. There is no evidence to support the concept that prolonged therapy with anticonvulsants prevents the development of epilepsy or significant neurological deficits. The potential risks of continuous prophylaxis are those predictable side effects, toxic manifestations, or idiosyncratic reactions that may be peculiar to the anticonvulsant drug selected for therapy. Drugs currently administered on a long-term basis to prevent febrile seizures are phenobarbital, diazepam, and valproic acid and, to a lesser extent, phenytoin and carbamazepine.
Phenobarbital is by far the most commonly used agent.
Side effects and toxic reactions are reported in up to forty percent of infants or children receiving phenobarbitol. Interference with higher cortical or cognitive functions, e.g., defect in short-term memory formation inattentiveness or decreased attention span defects in general comprehension. Disturbances in behavior and patterns of sleep are not predictable. They are the cause of discontinuation of therapy in up to 25 percent of patients. Animal and tissue culture studies, which are not at this time conclusive in regard to humans, raise questions as to more serious effects of phenobarbital and certain other anticonvulsant agents on the developing nervous system.