Therapeutic Effects of Single and Divided Doses of Piracetam for Children with Severe Breath Holding Spells

Abstract

Objectives: Breath-holding spells (BHS) are common in infancy and childhood. The severe episodes are frightening events for the families. The aim of this study was to evaluate therapeutic effects of piracetam in single daily dose and twice-daily dose of 40 mg/kg/day for treatment of severe spells. Methods: In this prospective clinical trial, 50 children with severe BHS referred to our outpatient university clinics of pediatric neurology and were randomized to single-dose and divided-dose groups. The single-dose group received a single daily dose of 40 mg/kg/day piracetam in the morning, and the divided-dose group received 20 mg/kg/dose of piracetam twice daily. Patients were followed for four months. The number of severe attacks/month before and after treatments were recorded. Results: In the single-dose group, 14 cases (60.9%) showed complete recovery, and nine (39.1%) showed relative recovery. In the divided dose group, eight patients (33.3%) showed complete recovery, 11 (45.8%) showed relative recovery, and five cases (20.8%) showed no recovery. This difference was statistically significant at P = 0.03. Conclusions: Our study showed that once-daily administration of piracetam could be more effective than twice-daily dose in the management of severe spells.