Main Entry Criteria. Adults with new-onset partial or secondarily generalized seizures

Comparator. Phenobarbital, primidone, phenytoin, or carbamazepine

Number of Patients. 622

Primary Outcome Variable. Failure to control seizures or unacceptable adverse events

Results. Significantly more patients were retained in the study with carbamazepine or phenytoin; primidone showed lowest level of retention in the study.

Main Entry Criteria. Children with partial seizures

Comparator. Phenobarbital or carbamazepine

Number of Patients. 33

Primary Outcome Variable. Seizure counts and psychometric testing

Results. No difference was seen between treatment groups.

Main Entry Criteria. Patients >16 years with at least two untreated tonic-clonic or partial with or without secondarily generalized seizures

Comparator. Phenobarbital, phenytoin, carbamazepine, or valproate

Number of Patients. 243

Primary Outcome Variable. Time to first seizure, time to 1-year remission, and adverse effects

Results. No difference was seen in time to first seizure and time to 1-year remission between treatment groups; phenobarbital has significantly more adverse effects.

Main Entry Criteria. Children aged 3 to 16 years with at least two untreated tonic-clonic or partial with or without secondarily generalized seizures

Comparator. Phenobarbital, phenytoin, carbamazepine, valproate

Number of Patients. 167

Primary Outcome Variable. Time to first seizure and time to 1-year remission

Results. No difference was seen between treatment groups.

Main Entry Criteria. Children aged 4 to 12 years with generalized tonic-clonic seizures

Comparator. Phenobarbital, phenytoin, or valproate

Number of Patients. 151

Primary Outcome Variable. Recurrence of seizure and adverse effects

Results. No difference was seen between treatment groups.

Main Entry Criteria. Children aged between 2 and 18 years in rural India with partial or generalized seizures

Comparator. Phenobarbital or phenytoin

Number of Patients. 94

Primary Outcome Variable. Time to first seizure and Connor Parent Rating Scale of behavior

Results. No difference was seen between treatment groups.

Main Entry Criteria. Patients with generalized convulsive status epilepticus

Comparator. Phenobarbital and optional phenytoin or diazepam and phenytoin

Number of Patients. 36

Primary Outcome Variable. Cumulative convulsion time and time from initiation of therapy to end of last convulsion (response latency)

Results. Cumulative convulsion time was shorter with phenobarbital (p<0.06) and response latency was shorter with phenobarbital (p<0.10).

Main Entry Criteria. Patients with overt or subtle status epilepticus

Comparator. Phenobarbital 15 mg/kg, diazepam 0.15 mg/kg followed by phenytoin 18 mg/kg, phenytoin 18 mg/kg, or lorazepam 0.1 mg/kg

Number of Patients. 570

Primary Outcome Variable. Cessation of all motor and electroencephalogram (EEG) activity within 20 minutes of start of therapy and no seizure recurrence within 40 minutes

Results. Lorazepam was significantly better than phenytoin (p = 0.002); no difference was seen among other treatment groups for overt status epilepticus; no difference was seen between all treatments for subtle status epilepticus.

Main Entry Criteria. Children with Lennox-Gastaut syndrome

Comparator. Phenobarbital or valproate

Number of Patients. 17

Primary Outcome Variable. Seizure counts

Results. Valproate significantly reduced seizures compared to placebo.

Main Entry Criteria. Neonates with a diagnosis of perinatal asphyxia

Comparator. Phenobarbital or phenytoin

Number of Patients. 17

Primary Outcome Variable. Seizure occurrence and adverse effects

Results. No difference was seen between treatment groups.

Main Entry Criteria. Neonates with an initial arterial pH less than or equal to 7.0 with a base deficit 15 mEq/L or more, Apgar score less than or equal to 3 at 5 minutes of age, or failure to initiate spontaneous respiration by 10 minutes of age

Comparator. Phenobarbital 40 mg/kg or placebo

Number of Patients. 31

Primary Outcome Variable. Occurrence of seizures

Results. No difference was seen between treatment groups (p = 0.11)

Main Entry Criteria. Neonates with EEG confirmed seizures

Comparator. Phenobarbital dosed to serum concentration of 25 μg/mL or phenytoin dosed to serum concentration of 3 μg/mL

Number of Patients. 59

Primary Outcome Variable. Control of seizures confirmed by EEG

Results. No difference was seen between treatment groups (p = 1); fewer than 50% in both groups had seizure control.

Main Entry Criteria. Children after first febrile seizure

Comparator. Daily phenobarbital, intermittent phenobarbital, no drug

Number of Patients. 355

Primary Outcome Variable. Seizure recurrence rate

Results. Significant decrease was seen in seizure recurrence rate in children receiving daily phenobarbital; no decrease was seen in rate with intermittent phenobarbital.

Main Entry Criteria. Children after first febrile seizure

Comparator. Daily phenobarbital or diazepam suppository every 8 hours with elevated temperature

Number of Patients. 195

Primary Outcome Variable. Seizure recurrence rate

Results. No difference was seen between the treatment groups.

Main Entry Criteria. Children after first simple febrile seizure

Comparator. Daily phenobarbital or placebo with antipyretic medication

Number of Patients. 79

Primary Outcome Variable. Seizure recurrence rate

Results. Phenobarbital significantly decreased seizure recurrence.

Main Entry Criteria. Children after first febrile seizure, which occurred before the second birthday

Comparator. Phenobarbital, phenytoin, or placebo

Number of Patients. 138

Primary Outcome Variable. Seizure recurrence rate

Results. Phenobarbital significantly reduced seizure recurrence compared to phenytoin or placebo.