Neuropsychological performance and quantitative EEGs were studied in 11 epileptic children, aged 7 to 14 years, both during treatment and without phenobarbital and mephobarbital, and in comparison to 13 matched controls, at Tulane University Medical School, New Orleans, LA. Barbiturates at therapeutic levels (10-40 mcg/ml) had no effect on the EEG in frequency bands 0.6 to 32 Hz. Compared to controls, the WISC-R Verbal, Performance, and Full Scale Scores, Bender-Gestalt, and Achenbach Behavior Rating Scale showed no significant change during barbiturate treatment; only the Stroop color/word test showed an adverse difference. Compared to scores off-drug in 8 subjects analyzed, adverse on-drug effects were found in the WISC-R Verbal, Stroop, and Achenbach aggression scales. Performance of the Bender-Gestalt improved during treatment with barbiturates. Irritability, oppositional attitude, and overactivity were reported in 6 of 11 subjects, but the parents of 4 elected to continue treatment. Mephobarbital caused less behavioral problems than phenobarbital. [1]
COMMENT. Contrary to a previous report of adverse effects of phenobarbital in younger children treated for febrile seizures, barbiturates appear to cause negligible cognitive impairments, only mild behavioral changes, and no effects on the EEG in older school age children treated for epilepsy.