Barbiturates
If you think about seizures as little brush fires in the brain, you want to put a blanket over or spray water on the fire. That’s what the phenobarbital does - Jacqueline French MD
HWN Suggests
The pros and cons of taking phenobarbital for seizures
Phenobarbital is not typically used as a first-line treatment for seizures anymore, says Megan Ehret, PharmD, an associate professor of pharmacy practice and science at the University of Maryland School of Pharmacy in Baltimore. “There are many newer medications, which may have fewer adverse effects and are better tolerated,” she says. Still, in some cases phenobarbital does have its advantages.
Featured
How phenobarbital revolutionized epilepsy therapy: The story of phenobarbital therapy in epilepsy in the last 100 years
Phenobarbital ‘‘revolutionized’’ therapy, but this has been a slow-burning revolution, with the drug only gradually gaining recognition in the years after its introduction.
Articles of Interest
Comparative Effectiveness of Levetiracetam vs Phenobarbital for Infantile Epilepsy
Our findings suggest that levetiracetam has superior effectiveness compared with phenobarbital as initial monotherapy for nonsyndromic epilepsy in infants. We estimate that for every 100 infants with epilepsy treated with levetiracetam instead of phenobarbital, 44 infants would be free from monotherapy failure instead of 16.
Most Commonly Prescribed Drug for Infantile Epilepsy May Also Be Most Effective
The barbiturate phenobarbital has been prescribed since the 1910s to infants with epilepsy but its use has been associated with lower IQ scores in children. Recently, physicians have been prescribing levetiracetam more frequently, as it has fewer side effects and appears to be well tolerated. But this use is off-label since the U.S. Food and Drug Administration approved the medication in 1999 only as an additional therapy for pediatric patients from 1 month of age to 16 years old.
Phenobarbital in Status epilepticus – Rediscovery of an effective drug
Phenobarbital (PB) is one of the oldest Antiseizure Medicines (ASMs), which is in clinical use since 1912. Its value in the treatment of Status epilepticus is currently discussed controversially. Phenobarbital has fallen out of favor in many countries across Europe because of reports of hypotension, arrhythmias, and hypopnea.
Phenobarbital Still Has a Role in Epilepsy Treatment
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.
Resources
Epilepsy Foundation
The advantages of phenobarbital are its long history of use, low cost, and effectiveness. It stays in the body for a long time, so the amount of medicine in the blood stays fairly steady even if it is taken only once a day. A disadvantage is that it makes many people sleepy and sometimes causes other changes in behavior.
