Comparative study of behavioural problems among epileptic children treated with phenobarbital with epileptic children treated with phenytoin

Phenobarbital is recommended by WHO as the first line drug for the treatment of partial and generalized tonic clonic epilepsies in developing countries, however several clinical trials have recorded higher frequencies of behavioural problems associated with Phenobarbital than with other drugs or no treatment. We compared the frequency of behavioural problems among epileptic children treated with phenobarbital with epileptic children treated with phenytoin. We conducted a case-control study to comparing of epileptic children treatment with neurological with epileptic children treated with phenytoin. Between November 2006 to March 2007, 74 children referred from child neurologic clinic who treated with phenobarbital or phenytoin for more than 2 months in Zahedan, assessed consecutively by the Rutters behaviour scale for children aged 6 years and older and by the preschool behaviour questionnaire for those 2-5 years. The mean scores on the behaviour scales did not differ significantly between the phenobarbital and phenytoin groups in children aged 6 years and older. Irretability, attention deficit, disobedience and lack of energy in phenobarbital group more than phenytoin group in 2-5 years old children. Several clinical trials have recorded higher frequencies (20-60%) of behavioural problems associated with phenobarbital than with other drugs but in our study evidence supports the acceptability of phenobarbital for epileptic children in developing countries.