The impact on cognition by phenobarbital in epilepsy treatment

Despite the development of successive generations of antiepileptic drugs, phenobarbital has retained a unique position in the therapeutic armamentarium and is still the most widely prescribed treatment for epilepsy worldwide. Although serious systemic side effects of phenobarbital are uncommon, its potential neurotoxicity remains a major concern. This is particularly so in the developed world. These neurotoxic effects include sedation, behavioral problems (in particular, hyperactivity), impaired cognition, depressed mood and affect. We conducted a case control study to evaluate the cognitive effects of phenobarbital treatment in epilepsy patients in rural China. The study patients were treated with phenobarbital monotherapy. Neuropsychological tests including Mini-Mental State Examination, Auditory Verbal Learning Test, Digit Span Test, Verbal Fluency Test, and Digit Cancellation Test were performed at baseline and during follow up. We did not fi nd any signifi cant change in the cognitive function, expect for improvement in verbal fl uency test among patients whose seizures control improved with phenobarbital. We concluded that there was no cognition impairment from treatment with phenobarbital in patients with epilepsy. On the other hand, language function of patients may improve due to the benefi cial effect of seizure control. Phenobarbital remains useful to treat epilepsy particularly in the developing countries. Neurology Asia 2011; 16 (Supplement 1) : 65 – 66