Benefits in Epileptics

Merritt and Putnam, Journal of the American Medical Association (1938),557 in the earliest clinical report observed: “In addition to a relief or a great reduction in the frequency of attacks, it was frequently noted by the parents of children that they were much better behaved, more amenable to discipline and did better work in school.”

557. Merritt, H. H. and Putnam, T. J., Sodium diphenylhydantoinate in the treatment of convulsive disorders, JAMA, 111: 1068-1073, 1938.

McCartan and Carson, Journal of Mental Science (1939),556 while reporting on the efficacy of PHT in controlling seizures in a group of twenty patients, noted: “Irritability and violent episodes are markedly diminished in frequency and severity. The patients are bright and alert, and there is a subjective feeling of well-being. “Patients comment on their increased efficiency, and the absence of drowsiness which they experienced on bromide and phenobarbital treatment.”

556. McCartan, W. and Carson, J., The use of sodium diphenylhydantoinate, J. Ment. Sci., 85: 965-971, 1939.

Kimball and Horan, Annals of Internal Medicine (1939),535 in a study of 220 children treated with PHT, reported that apart from the influence on convulsions, there are other benefits from the use of PHT. The authors noted that there is a marked change in mental state and personality, evidenced by a definite improvement in memory, concentration, and sense of composure, with a return of social interest.

535. Kimball, 0. P. and Horan, T. N., The use of Dilantin in the treatment of epilepsy, Ann. Intern. Med., 13: 787-793, 1939.

Ross and Jackson, Annals of Internal Medicine (1940),313 noted that in consonance with the alleviation of seizures almost all reports on PHT remark on the improvement in behavior, well-being, cooperation, alertness, general attitude, irritability, temperament, and personality of many patients. Their findings in a study of seventy-three patients were consistent with these reports.

313. Ross, A. T. and Jackson, V., Dilantin sodium: its influence on conduct and on psychometric ratings of institutionalized epileptics, Ann. Intern. Med., 14: 770-773, 1940.

Frankel, Journal of the American Medical Association (1940),106 in a study involving forty-eight patients reported that, besides being an effective anticonvulsant, PHT has the advantage of not producing the sedative effects of the other anti-convulsants. The author noted that the personality of the epileptic patient treated with PHT is remarkably improved.

106. Frankel, S. I,. Dilantin sodium in the treatment of epilepsy, JAMA,114: 1320-1321, 1940.

Fetterman and Shallenberger, Diseases of the Nervous System (1941),95 observed that an outstanding feature of the benefit of PHT is an amazing improvement in personality.

95. Fetterman, J. L. and Shallenberger, W. D., Further studies in Dilantin sodium therapy of epilepsy, Dis. Nerv. System, 2: 383-389, 1941.

Bakwin and Bakwin, Journal of Pediatrics (1951),539 found PHT beneficial for irritability, hypermotility and variability of behavior in epileptic children, even when seizures were not the major problem.

539. Bakwin, R. M. and Bakwin, H., Psychologic aspects of pediatrics: epilepsy, J. Pediat., 39: 766-784, 1951.

Sultan, Chouinard and Beaudry, Progress in Neuropsychopharmacology and Biological Psychiatry (1990),3101 present 5 case reports of schizophrenic patients with neuroleptic-induced supersensitivity psychosis (SSP). Of the five patients, only one was treated with PHT. A 46-year-old female with a 21-year history of neuroleptic treatment was poorly controlled on pimozide 30 mg po tid, fluspirilene 32 mg IM once weekly, and clonazepam 5 mg daily. The patient was agitated, labile, and childish in her behavior, and felt convinced that her husband was an imposter. She was admitted to participate in a research protocol, but suffered a grand mal seizure during clonazepam withdrawal. PHT was started at 150 mg daily, leading to a marked reduction in psychotic symptoms. The patient was discharged on haloperidol and PHT with considerable improvement in daily functioning that was maintained up to 3 years.

3101. Sultan, S., Chouinard, G., and Beaudry, P., Antiepileptic drugs in the treatment of neuroleptic-induced supersensitivity psychosis, Prog. Neuropsychopharmacol. Biol. Psychiatry, 14: 431-38, 1990.

See also: Psychoses