Dilantin

[Gowgow]

My husband was recently diagosed with glioblastoma multiforme brain cancer.  The neurosurgeon put him on Dilantin "for life."  He isn't even going to check blood levels.  My husband has not had any seizures.  Does this seem appropriate?

[Fernando Roque, MD]

Hi.  Two meta-analyses (an analytic study combining the results of several clinical trials) done by Sirven, et al (2004) and Tremont-Lukats, et al (2008) showed no benefit to giving anti-epileptic drugs in general, and Dilantin in particular, to patients with brain tumors in order to prevent an initial seizure.  Your husband may have an option not to take Dilantin since there's no difference in outcome.

You can check out the articles yourself:

www.mayoclinicproceedings.com/pdf%2F7912%2F7912a1.pdf
www.cochrane.org/reviews/en/ab004424.html
www.asco.org/.../Abstracts?&vmview=abst_detail_view&confID=26&abstractID=585 - 41k

[monique58]

My husband was initially on dilatin for seizure control.  This is a dirty drug.  Based on our and other brain tumor survivors consensus, we like Keppra the best for seizure control.  Another anti-epileptic drug is Tegretol.

Ask your doc about adding Keppra or Tegretol and weaning off of Dilatin.  Another reason he may have put your husband indefinetly on Dilatin is because it is available via IV.

Take your doc to a neurologist who is familiar with Brain tumors (ask how many of his patients have tumors). It is the neurologist's job to manage medications.  She/he is most familiar with medications your husband will need.  Neurosurgeon focus is not medication management.  I hope this helps.

lastly, please join a brain tumor support group.