Neurocognitive effects of phenobarbital discontinuation in epileptic children.
OBJECTIVE
Phenobarbital (PB) is the most widely used antiepileptic drug in the world, but its possible deleterious cognitive and behavioral side effects remain an important concern among physicians and patients.We therefore investigated whether discontinuation of PB in children with epilepsy is accompanied by improvement in cognitive function.


METHODS
Neuropsychiatric performance was evaluated with the Wechsler Intelligence Scale for Children-Revised (WISC-R), in two consecutive 7-month periods, in two groups of children with epilepsy 6-12 years old who had been seizure-free for at least 2 years and whose only antiepileptic drug was PB. The case group comprised 24 patients who discontinued PB, and the control group was comprised of the 21 children who continued to take PB.


RESULTS
Discontinuation of PB improved Total IQ in the case group compared to the control group (P = 0.027). This increase was mostly in performance (nonverbal) items; verbal items remained almost unchanged.


CONCLUSIONS
These findings suggest that PB affects cognitive function, and the performance (nonverbal) deficits are diminished after discontinuation of therapy.
Tonekaboni
Seyed Hassan
SH
Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Beyraghi
Narguess
N
Tahbaz
Hosseinzadeh Sahar
HS
Bahreynian
Seyed Abdolmajid
SA
Aghamohammadpoor
Mehran
M
D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D003071:Cognition / Q000187:drug effects*; D004827:Epilepsy / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D007360:Intelligence / Q000187:drug effects*; D008297:Male; D010634:Phenobarbital / Q000494:pharmacology* / Q000627:therapeutic use; D011446:Prospective Studies; D014888:Wechsler Scales
D000927:Anticonvulsants; D010634:Phenobarbital