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Phenobarbital for the Treatment of Epilepsy in the 21st Century: A Critical Review
Author(s) -
Kwan Patrick,
Brodie Martin J.
Publication year - 2004
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.0013-9580.2004.12704.x
Subject(s) - tolerability , phenobarbital , observational study , epilepsy , developing country , randomized controlled trial , clinical trial , medicine , developed country , real world evidence , intensive care medicine , psychiatry , psychology , pharmacology , adverse effect , economic growth , surgery , environmental health , population , economics
Summary: Phenobarbital (PB) is the most widely used antiepileptic drug (AED) in the developing world and remains a popular choice in many industrialized countries. Meta‐analyses of randomized controlled trials suggest that few differences in efficacy exist between PB and other established AEDs, but its possible deleterious cognitive and behavioral side effects remain a concern in the developed world. In contrast, high degrees of efficacy and tolerability in everyday clinical use have been demonstrated consistently in observational studies in developing countries. We propose that a pragmatic, comprehensive outcomes program be carried out, perhaps under the aegis of the Global Campaign Against Epilepsy, to optimize the conditions of the use of PB, so that more people around the world can benefit from this cost‐effective medication and live more fulfilling lives.