The first drug usually given for neonatal seizures is:

The first drug usually given for neonatal seizures is:

• A. Phenytoin
• B. Phenobarbital (Donnatal)
• C. Diazepam
• D. Valproate

Answer: (B)

Phenobarbital is used first for neonatal seizures because it reliably suppresses seizures by enhancing GABAergic inhibition in the immature brain, providing quick and effective control. In newborns, its long-standing clinical use and pharmacokinetics allow rapid achievement of therapeutic levels with a manageable dosing schedule. While it can cause respiratory depression and sedation, these risks are offset by careful monitoring and support. Other drugs like diazepam, phenytoin, or valproate tend to have less reliable seizure control in neonates or higher risks in this population, making them less suitable as the initial therapy.

Phenobarbital is used first for neonatal seizures because it reliably suppresses seizures by enhancing GABAergic inhibition in the immature brain, providing quick and effective control. In newborns, its long-standing clinical use and pharmacokinetics allow rapid achievement of therapeutic levels with a manageable dosing schedule. While it can cause respiratory depression and sedation, these risks are offset by careful monitoring and support. Other drugs like diazepam, phenytoin, or valproate tend to have less reliable seizure control in neonates or higher risks in this population, making them less suitable as the initial therapy.