side effects of dilatin

My husband has been on dilatin for several years for seizures he takes 800mg a day, his behavior has changed alot, he has even complained about nails and teeth texture changing. But he stays tired alot. He has recently left me after 25yrs of marriage and I believe the meds has alot to do with his personality change. Any advise
Thanks
She

[dr_simran]

Hello she11,
The following information on dilantin would be of great help.
Phenytoin sodium is a commonly used antiepileptic. Phenytoin acts to dampen the unwanted, runaway brain activity seen in seizure by reducing electrical conductance among brain cells by stabilizing the inactive state of voltage gated sodium channels. Aside from seizures, it is an option in the treatment of trigeminal neuralgia as well as certain cardiac arrhythmias.
At therapeutic doses, phenytoin produces horizontal gaze nystagmus, which is harmless but occasionally tested for by law enforcement as a marker for alcohol intoxication (which can also produce nystagmus). At toxic doses, patients experience sedation, cerebellar ataxia, and ophthalmoparesis, as well as paradoxical seizures. Idiosyncratic side effects of phenytoin, as with other anticonvulsants, include rash and severe allergic reactions.
It has been suggested that phenytoin causes a reduction in folic acid levels, predisposing patients to megaloblastic anemia. Folic acid is presented as polyglutamate in foods, it is then converted into monoglutamates by intestinal conjugase. Phenytoin acts by inhibiting this enzyme therefore causing folate deficiency
Phenytoin may accumulate in the cerebral cortex over long periods of time, as well as causing atrophy of the cerebellum when administered at chronically high levels. Despite this, the drug has a long history of safe use, making it one of the more popular anti-convulsants prescribed by doctors, and a common "first line of defense" in seizure cases. Phenytoin has been associated with drug induced gingival enlargement (hyperplasia) in the oral cavity probably due to above mentioned folate defiency. Plasma concentrations needed to induce gingival lesions has not been clearly defined. Effects consist of the following: bleeding upon probing, increased gingival exudate, pronounced gingival inflammatory response to plaque levels, associated in some instances with bone loss but without tooth detachment.
Following almost 200 studies of 11 anti-seizure drugs, the FDA has also warned of an increased suicide risk for any patients treated with certain anti-seizure drugs. The study of 44,000 patients found that patients whose epilepsy is treated with drugs face about twice the risk of suicidal thoughts compared to placebo-takers. Although phenytoin was not named in the study, the FDA announced that it expected the risk applied to every epilepsy drug

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