Late cognitive effects of early treatment with phenobarbital.
We previously reported that IQ was significantly lowered in a group of toddler-aged children randomly assigned to receive phenobarbital or placebo for febrile seizures and there was no difference in the febrile seizure recurrence rate. We retested these children 3-5 years later, after they had entered school, to determine whether those effects persisted over the longer term and whether later school performance might be affected. On follow-up testing of 139 (of the original n = 217) Western Washington children who had experienced febrile seizures, we found that the phenobarbital group scored significantly lower than the placebo group on the Wide Range Achievement Test (WRAT-R) reading achievement standard score (87.6 vs 95.6; p = 0.007). There was a nonsignificant mean difference of 3.71 IQ points on the Stanford-Binet, with the phenobarbital-treated group scoring lower (102.2 vs 105.7; p = 0.09). There were five children in our sample with afebrile seizures during the 5-year period after the end of the medication trial. Two had been assigned to phenobarbital, and three had been in the placebo group. We conclude there may be a long-term adverse cognitive effect of phenobarbital on the developmental skills (language/verbal) being acquired during the period of treatment and no beneficial effect on the rate of febrile seizure recurrences or later nonfebrile seizures.
Department of Psychiatry, University of Washington School of Medicine, Seattle, USA.
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Sulzbacher
J R
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Farwell
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Temkin
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Lu
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Hirtz
D002648:Child; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D008297:Male; D019954:Neurobehavioral Manifestations / Q000187:drug effects*; D010634:Phenobarbital / Q000494:pharmacology / Q000627:therapeutic use*; D003294:Seizures, Febrile / Q000188:drug therapy / Q000503:physiopathology*
D010634:Phenobarbital