Neurocognitive Effects of Phenobarbital Discontinuation in children

Objectives: Phenobarbital (PB) is the most widely used antiepileptic drug in the world, but its possible deleterious cognitive and behavioural side effects remain an important concern among physicians and patients. We attempt to investigate whether discontinuation of PB in epileptic children was accompanied by improvement in cognitive function. Design and Methods: Evaluation of neuropsychiatric performance was performed by Wechsler intelligence Scale for Children-Revised (WISC-R), in 2 consecutive periods of 7 months interval, in 2 groups of epileptic children between 6-12 years old who were seizure free for at least 2 year and who were taking PB as antiepileptic drug. The case group consisted of 24 patients for whom PB was discontinued and the control group consisted of 21 children who continued to take PB. Results: Results indicated that discontinuation of PB improved total IQ scored compared to control group (p=0.027), and this increase was mostly in performance (nonverbal) items while verbal items remained almost unchanged. Conclusion: These findings suggest that PB affects cognitive function; and the performance (nonverbal) deficits are reversible after therapy discontinuation.