Neurocognitive effects of phenobarbital discontinuation in epileptic children

PurposePhenobarbital (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.MethodsNeuropsychiatric 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.ResultsDiscontinuation 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.ConclusionThese findings suggest that PB affects cognitive function, and the performance (nonverbal) deficits are diminished after discontinuation of therapy.