Phenobarbital Still Has a Role in Epilepsy Treatment

Abstract

Phenobarbital, the oldest of the currently available antiepileptic drugs, has lost its popularity in this era of multiple new drugs and is seldom used after infancy in developed countries. We report a group of patients with generalized epilepsy in whom phenobarbital proved to be the drug of choice. Phenobarbital monotherapy was given to 20 patients with idiopathic generalized epilepsy beginning in childhood but persisting into adulthood. All the patients have normal intelligence and neurologic status. The electroencephalogram has either been normal or showed generalized spike-wave discharges. All patients' seizures are fully controlled on once-a-day low-dose phenobarbital with no side effects. Attempts to discontinue the medication have led to recurrence of seizures. We believe that in patients with mild generalized tonic-clonic seizures phenobarbital could still be the drug of choice since it is cheap, safe, convenient, and effective. (J Child Neurol 1999;14:820-821).

Get full access to this article

View all access options for this article.

References

Painter MJ , Gaus LM Phenobarbital, In Wyllie E (ed): The Treatment of Epilepsy: Principles and Practices. Philadelphia , Lea & Febiger, 1993, pp 900-908.

Dreifuss FE : Generalized tonic clonic seizures, in Morselli PL , Pippenger CE , Penry JK (eds): Anti-Epileptic Drug Therapy in Pediatrics. New York, Raven Press , 1983, pp 145-151.

Duchowny M. , Harvey AS Pediatric epilepsy syndromes: An update and critical review. Epilepsia 1996;37(Suppl. 1):S26-S40.

Hauptmann A. : Luminal bie epilepsia. Munch Med Wochenschr 1912;59:1907.

Mattson RH , Cramer JA , Collins JF , et al: Comparison of carbamazepine, phenobarbital, phenytoin and primidone in partial and secondarily generalized tonic-clonic seizures. N Engl J Med 1985;313:145-151.

Prichard JW , Mattson RH : Barbiturates: An update, Pedley TA , Meldrum BS (eds): Recent Advances in Epilepsy 3. Edinburgh ; Churchill Livingstone, 1986, pp 261-277.

Farwell JR , Lee YJ , Hirtz DG , et al: Phenobarbital for febrile seizures—effect on intelligence and on seizure recurrence. N Engl J Med 1990 ;322:364-369.

Gallagher BB , Freer LS : Barbituric acid derivatives, in Fry HH , Janz D (eds): Antiepileptic Drugs. New York, Springer-Verlag , 1985, pp 421-447.

Yerby MS : Pregnancy and teratogenesis, in: Trimble MR (ed): Women and Epilepsy. New York, John Wiley & Sons, 1991, pp 163-191.

10.

Loiseau P. , Duche B. : Phenobarbital, in Dam M , Gram L (eds): Comprehensive Epileptology. New York, Raven Press, 1990, pp 579-591.