Phenobarbital and Suicidality: A Case Report

  • Sreeja Sahadevan Malankara Orthodox Syrian Church Medical College Kolenchery
  • Rajan Nishanth Jayarajan Cairns and Hinterland Health Service Queensland Health
  • Jayaraj Kezhukkut Amala Institute of Medical Sciences Thrissur
  • Thekkanath Paul Antony Amala Institute of Medical Sciences
  • Damodaran Sreekumar Amala Institute of Medical Sciences

Abstract

Phenobarbital is widely-used in primary care for the treatment of epilepsy, headache and insomnia in India. There are certain scenarios in which its use must be monitored closely. We report a case wherein a lady was suffering from symptoms of mild depression following a stressor. After being prescribed Phenobarbital for headache and insomnia by a primary care physician, she developed suicidal ideation and made a suicide attempt. Clinicians should pick up possible appearance or worsening of depressive symptoms or emergence of suicidal ideation in patients on Phenobarbital and consider changing the treatment.

Author Biographies

Sreeja Sahadevan, Malankara Orthodox Syrian Church Medical College Kolenchery

Senior Resident

Department of Psychiatry

Rajan Nishanth Jayarajan, Cairns and Hinterland Health Service Queensland Health

Registrar,

Remote Mental Health

Jayaraj Kezhukkut, Amala Institute of Medical Sciences Thrissur

Associate Professor

Department of Medicine

Thekkanath Paul Antony, Amala Institute of Medical Sciences

Professor

Department of Medicine

Amala Institute of Medical Sciences

Damodaran Sreekumar, Amala Institute of Medical Sciences

Professor

Department of Psychiatry

References

Mani KS, Rangan G, Srinivas HV, Sridharan VS, Subbakrishna DK. Epilepsy control with phenobarbital or phenytoin in rural south India: the Yelandur study. Lancet 2001; 357(9265):1316-20.

Nadkarni S, Devinsky O. Psychotropic effects of antiepileptic drugs. Epilepsy Curr 2005; 5(5):176-81.

Gureje O, Simon GE, Ustun TB, Goldberg DP. Somatization in cross-cultural perspective: a World Health Organization study in primary care. Am J Psychiatry 1997;154(7):989-95.

Kalinin VV. Suicidality and antiepileptic drugs. is there a link ? Drug Safety 2007; 30(2):123-42.

Brent DA, Crumrine PK, Varma R, Brown RV, Allan MJ. Phenobarbital treatment and major depressive disorder in children with epilepsy: a naturalistic follow-up. Pediatrics 1990; 85(6):1086-91.
Published
2017-02-04