Dr. Steve Wolf: Phenobarbital is one of our oldest anti-seizure medications that have been around. It's indicated for both seizure types. The major problem with it is sedation, sleepiness. That's why the newer medications have a lot less sleepiness and side effects and waking issues.
Patty McGoldrick: Now it still is used a lot of times in infants, children who present with neonatal seizures, and that's one of the first medications that's given to them. It's also used for people who present in status, which is prolonged seizures, and who may be in the emergency room. Not necessarily as the first medication that's used for that, but somewhere down the line.
Dr. Wolf: The problem is in the emergency room, when you use it, it can really knock you out, and put you to sleep. And of course, if you give too much of it, it actually can affect your respiration.
Patty: Now, the other big issue with phenobarbital is that we've been using it for years to control seizures in newborns and in infants. And actually, the latest research has shown it can cause much more cognitive damage than we initially thought. So we're trying not to use that as rapidly as we did in the past. We use some of the newer medications. We try to get children off phenobarbital pretty quickly if they were using it.
Dr. Wolf: There were studies in the 80's showing that it can affect hyperactivity in young children, as well as reading scores and attention scores. So again, this drug can have a lot of potential cerebral side effects. That's why it's nice about some of the newer medications that are out there that might have less cognitive effects. So it's important to discuss with the people taking care of you whether this is the right medication for you, and what are the other choices.