Dilantin

[Keneley]

I am a 51 year-old male, with mild epilepsy, which has been controlled well by Dilantin since my first seizure, 20 years ago. Currently I have no neurologist (mine retired) and my family doctor is the doctor who writes my Dilantin perscription, so he is not a neurologist. I have only had 3 grand mal seizures in my life, the first one unexpectedly, the other two because I stopped taking the medication on my own for the second one, and overuse of Metamucil caused the third. I have had no grand mal seizures for 10 years. I do have mild confusion situations 2 or 3 times a month at the most, mostly when I am lacking proper sleep or am stressed, which only cause me to be confused when reading or writing. I can function perfectly fine when they occur, and usually they clear up after an hour on the average.  These are not increasing in occurrence by the way. My question is this, can a person in my situation, and at my age take Dilantin indefinitely? And could these occurences be a side effect of Dilantin?

Thank You,
Ken

[CCF-Neuro-M.D.-JT]

Whether or not to stop an antiepileptic medication depends on many factors and should be discussed with a neurologist as various things will come into play such as driving. If you have had no significant problems with the dilantin such as increased gum growth, dizziness and imbalance then we do have patients who continue taking it indefinitely. You should have your dilantin level checked sporadically to make sure it's not too high or too low as well as a homocysteine level.  Homocysteine is a protein in your body that has been recently linked to heart disease and stroke and has been known to accumulate in patients on dilantin.  This is because dilantin can deplete your body's level of folate ( a vitamin that keeps the homocysteine level down.) Finally, an uncommon side effect with long term use is cerebellar wasting that is manifest as eye movement problems, imbalance and dizziness.

As for the episodes of confusion, it could be a possible manifestation of the dilantin level being too high although this doesn't clear in an hour. A new type of seizure for you such as complex partial seizures which manifest as confusion are another possiblity.
Hope that helps.

[Binkie]

Hi-I have an out of print book about Dilantin called,
"A Remarkable Medicine Has Been Overlooked" wherein the author
extolls the virtues of this medication. However, at higher
doses (200mg daily)it often causes teeth to loosen and fall
out. That is what it did to my mom.
Binkie

[Keneley]

I have never heard of that in reading about Dilantin. I have been taking 400 mg./day for 20 years and my teeth are quite happily in place. I have also heard that gums can grow as well, but I have never had any trouble with that either. I suppose that side effects are different with everyone. I hope your mom has not had any other trouble.
Ken

[apreacher]

My neighbour will be very normal and suddenly express recently the symptoms of slurred speech, difficulty in depth perception,vomiting, dizziness, drowsiness, fatigue, nausea, vomiting, coordination difficulties, release of hostility and other paradoxical effects such as irritability, excitability ,confusion, depression, sleep problems, forced sleep, anxiety, chills, sweating, heart rate and blood pressure increases.. causes?

His doctor had previously had taken him of his epileptic medecine for the last six weeks and was that the cause?

[puma]

It sounds like either discontinuation withdrawal from the Dilantin;

or possibly alcohol or benzodizapine,( Valium, Klonopin, Xanax, Librium,) withdrawal if he took any of those things and suddenly stopped. Those are life threatening withdrawal symptoms especially if he has the high blood pressure and delirium tremens, which the disorientation may be part of. He should see a doctor ASAP.

[MOFENNELL]

A related discussion, WHAT IS AN ACCEPTABLE DILANTIN LEVEL was started.