Efficacy of Phenobarbital, Italept, and Topamax in the Treatment of Neonatal Seizures:A Double-Blinded Cross-Sectional Study of the Iranian Population.

Objectives: Seizures are changes in the electrical activity of the brain. These changes can cause significant or otherwise asymptomatic symptoms. Phenobarbital and phenytoin are known drugs for treating neonatal seizures, but little clinical experience exists using other drugs. The present study aims to evaluate the efficacy of other drugs, such as Levetiracetam and Topiramate, compared to Phenobarbital in treating neonatal seizures.

Materials & methods: In a double-blind clinical trial, all neonates admitted to a referral hospital for two years (2020-2022) due to seizures were included. All of the neonates were treated with a dosage of 10-40mg/kg/state IV Phenobarbital to control the acute seizure. After that, they were divided into three groups with specific treatment programs. Groups were ordered with oral Phenobarbital 5mg/kg/day maintenance (first group), oral Topiramate 3-8mg/kg/day (second group), and 10-40mg/kg/day Levetiracetam (third group). Seizures and potential side effects were investigated through interviews and medical EEG tests. The data was analyzed using the Chi-square test.

Results: Sixty infants (20 neonates in each group) were studied. Phenobarbital, Italept, and Topiramate did not significantly differ in controlling convulsions and changes related to brain paroxysmal discharges.

Conclusion: Due to the long treatment duration and side effects, it is essential to choose the appropriate drug for treating treatment-resistant seizures of neonates. The present study found that Phenobarbital, Levetiracetam, and Topiramate are equally effective in controlling seizures. These medications can also help eliminate abnormalities in children's brain paroxysmal.