(FDA approved in bold)

• Generalized tonic-clonic, psychomotor, and partial seizures (monotherapy and adjunctive, children and adults)
  
• Status epilepticus
  
• Seizures resulting from cerebral malaria
  
• Sedation
  
• Anxiety
  
• Alcohol or barbiturate withdrawal

• Phenobarbital raises seizure thresholds or alters seizure patterns in animal models
  
• The exact mechanism of action is unknown but likely enhances GABA-A receptor activity
  
• Depresses glutamate excitability, alters sodium, calcium, and potassium channel conductance

• Seizures – should decrease by 2 weeks

• Seizures – goal is the remission of seizures. Continue as long as effective and well-tolerated. Consider tapering and slowly stopping after 2 years without seizures, depending on the type of epilepsy

• Increase to highest tolerated dose
  
• Epilepsy: consider changing to another agent, adding a second agent or referral for epilepsy surgery evaluation. When adding a second agent, keep in mind drug interactions

• Epilepsy: drug interactions complicate multi-drug therapy. Phenobarbital is a second-line agent in developed countries due to AE profile

• CBC, hepatic and kidney function panels at baseline and every 6 months