Barbiturate Anticonvulsants as a Cause of Severe Depression

Abstract

In Reply.— I appreciate the comments of Drs Barabas and Matthews. It is nice to receive additional clinical validation for our observations of an association between phenobarbital treatment and affective symptomatology in epileptic patients. A recently published study of adult epileptic patients has also found an association between phenobarbital treatment and depressive symptomatology.1 It is of interest to learn that other barbiturate anticonvulsants as well may be associated with depression. Drs Barabas and Matthews emphasize three points that we touched on, too—the importance of a high index of suspicion for depression in patients treated with phenobarbital, the possibility that such symptoms may occur at nontoxic doses, and the findings of depression in young children such as lability, irritability, and agitation that may be termed "hyperactivity."