{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T03:50:00Z","timestamp":1781754600057,"version":"3.54.5"},"reference-count":13,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T00:00:00Z","timestamp":1535500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Despite phenobarbital (<jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content>) being a key component in status epilepticus (SE) treatment algorithms for decades, it has fallen out of favor compared to newer nonsedating medications due to potential for respiratory suppression and prolonged sedation. We retrospectively analyzed all nonintubated patients with refractory SE treated with parenteral <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content>. Forty patients were identified as having received <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> in the neurologic intensive care unit at Mayo Clinic over a 7\u2010year period through our pharmacy dispensing database. Patients who received <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> for maintenance therapy, those replenishing subtherapeutic levels, those who were already intubated, and those receiving PB for a non\u2010<jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content> indication were excluded. Clinical data, prior treatments, therapeutic response, and outcome were reviewed. Eight patients were identified. Ages ranged from 24 to 77\u00a0years (median\u00a0=\u00a064 years); all had focal <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content>, and none was comatose. Seizure activity improved acutely following <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> administration in seven and stopped in six. Dosages ranged from 5 to 19.8\u00a0mg\/kg (median\u00a0=\u00a010.1\u00a0mg\/kg); none required intubation, and one received supplemental oxygen. Patients received a median of four antiepileptic drugs prior to <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content>. Median interval between first drug and <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> was 23.5\u00a0hours. Glasgow Coma Scale score did not change following <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> administration. One patient required intervention for hypotension. Moderate\u2010dose parenteral <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> was effective in attaining seizure control in a significant proportion of noncomatose refractory <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content> patients. None required ventilatory support. <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> dosages below those in recent guidelines may be sufficient to stop <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content> without clinically significant cardiopulmonary complications.<\/jats:p>","DOI":"10.1111\/epi.14488","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T10:42:32Z","timestamp":1535625752000},"page":"193-197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Parenteral phenobarbital in status epilepticus revisited: Mayo Clinic experience"],"prefix":"10.1111","volume":"59","author":[{"given":"Sara","family":"Hocker","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Clark","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, Department of Neurology, Psychiatry, and Emergency Medicine Mayo Clinic Rochester MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Britton","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182591ff1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000881"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-016-0389-5"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809173391202"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.5698\/1535-7597-16.1.48"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-012-9695-z"},{"key":"e_1_2_7_8_1","first-page":"499","article-title":"Barbiturates in the treatment of status epilepticus","volume":"34","author":"Goldberg MA","year":"1983","journal-title":"Adv Neurol"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199804023381407"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2013.578"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.59.2.205"},{"key":"e_1_2_7_12_1","unstructured":"Physicians\u2019 Desk Reference. Available from:http:\/\/www.pdr.net\/drug-summary\/Phenobarbital-Tablets-16-2-mg-32-4-mg-64-8-mg-97-2-mg-phenobarbital-2943.3876. Accessed November 11 2017."},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2007.04.012"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2012.01.012"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fepi.14488","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.14488","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T18:47:22Z","timestamp":1694890042000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.14488"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,29]]},"references-count":13,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1111\/epi.14488"],"URL":"https:\/\/doi.org\/10.1111\/epi.14488","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,29]]},"assertion":[{"value":"2017-11-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}