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Doctors' Answers to "Frequently Asked Questions" - Dilantin
These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Question: I read that Dilantin may safely treat anxiety, depression, and low energy and aid concentration at a dose of 100 mg per day. I experience these symptoms frequently, although they are fairly mild, so I would like to try Dilantin. I have successfully treated my mild depression with St. John's Wort, but Dilantin at this dosage is much less expensive. Is is safe to drink alcohol while taking 100 mg of Dilantin daily? Also, would it interfere with the use of Doxicyclene to treat acne?
Answer: Not a usual treatment for this problem and potentially a toxic drug. Alcohol is probably ok, depending on how much sedation you experience.
Question: can dilantin be given for depression and how useful
prozac does not work
please give me the name of the best drug for depression
Answer: Dilantin is usually of no help in depression. There are several classes of drugs that are useful in depression and the effectiveness varies by individual. You need to stick with one md who is comfortable using the different medications and go through them one at a time.
Question: Following a grande-mal seizure, I was diagnosed with a brain metastasis from a primary lung tumor. The brain met was treated sucessfullt with Gamma-Knife. Subsequently I had partial seizures. I started with Dilantin and after 4 weeks developed a whole-body rash. I was then given Tegretol and Depakote but the rash stayed on for 8 weeks. I was then taken off Tegretol and Depakote, given Neurontin 1500 mg. per day and 60mg Prednisone per day. Immediately the itching went away and the rash faded. Now, 3 weeks later I have tapered off the Prednisone and the rash is coming back -- slowly but much the same. Could the Neurontin be the culprit or might this be a flare-up of the original rash precipitated by the Prednisone taper?
Answer: Probably the original rash, the rash from dilantin often lasts up to 2-3 months. But, if it persists another couple of weeks, you need further testing. The neurontin would rarely be a suspect with rashes.
Question: I have been on Dilantin for almost two years now and I believe I am experiencing some of the side effects.
I was just wondering if it is possible to experience these side effects after being on the medication for this long.
I take 4/100mg pills a day. The side effects I believe I am having are mood swings, I have a hard time controlling my
emotions. I am a University student and I feel like I cannot concentrate on my classes and that I am almost feeling
dumber when I compare myself to when I was not on the medication. I also am having problems remembering things, mostly my short
term memory. The best way I can describe myself is that I feel very unbalanced, I would not say it's depression, but I do
feel like I am basically skipping a beat so to speak. Any insight into what I have said would be greatly appreciated.
Answer: There are several possible problems with dilantin. One is an allergic type reaction that can occur at any time and comes with a rash, fever, confusion etc. Possibly this is what is going on, but sounds somewhat atypical. Another, is that your dosage is too high. If above 20, you'll act somewhat drunk. Have your md check your levels if this hasn't been done recently.
Question: I've been on Dilantin for approx. 2 year for seizures.
I was told of the possibility of effects on the gums, and that I'd be an unlikely candidate, but that was the only
side effect brought to my attention.
Last summer I had a terrible outbreak of cystic pimples on my face (at 40 years old), such that I was inclined to stay indoors. I went to a dermatologist and was brought under control with antibiotics. While it was never confirmed what the outbreaks were from, I thought it may have been staph or similar from a pollution/sewage problem at my local beach. The outbreak returned, but was brought under control again with antibiotics and topical treatment.
Just today in a sepearate discussion about Dilantin, Accutaine, I was told that Dilantin can cause cystic outbreaks. I've search high and low on the internet to find something, but this is not stated anywhere I've looked.
Hoping I could get this cleared up.
Answer: Not one that I've seen. I would contact the scientific department of Parke-Davis-800-223-0432-they can direct you to any studies/research here.
Question: Recently I experienced an increase in my dilantin level to 52 on one occasion and 42 on another. This led to grand mal seizure activity which I had never experienced. I have been treated since 1958 for absence or petit mal seizures, no one knows which for sure.
At the time of the increased dilantin level there had been no changes in my lifestyle and no apparent reason for the increase..except one possibility. Because of a heart murmur, my dentist, in corroboration with a cardiologist at Kaiser, insists that I take an antibiotic before each appointment. Two days before the discovery of the increased dilantin level, I had taken four capsules of amoxicillin 500mg. This situation of increased dilantin level occured twice, coincidentally a few days after the intake of amoxicillin. No other medication was administered by the dentist including novacaine. My neurologist and pharmacist insist there is no connection but neither do they have an explanation for the increased dilantin levels. On one trip to ER following a seizure, the doctor on duty asked me if I had taken an antibiotic but at that time I didn't remember the amoxicillin and when I mentioned it to my neurologist she insited there was no connection.Is there any other possible answer?
Answer: Easy to check daily levels prior to during and after use of the antibiotic. Sounds like the metabolism is changing due to the drug. You might call the company for more information Parke-Davis 800-223-0432.
Question: I had two surgeries in July 1998 to remove a tumor (neurocytoma)
My Doctor put me on Dilantin...400mg a day. I had had the
tumor since I was a baby...i had one cell when i was born..and
all my life i've been overweight..my doctor said that after
surgery and 6 1/2 weeks of radiation...when i got my immune
system back to normal and started getting active again...that
I could lose up to 80 pounds...well i've done everything...
i've joined the local "YMCA," go walking with my friends 3
times a week and, above all i've changed my eating habits...
but I haven't lost any weight...i was wondering if it was the
dilantin...does this drug make you retain water, gain weight,
...it seems like no matter what i do...i can't lose weight.
HELP...ALL I WANT TO DO IS LOSE SOME WEIGHT...BUT EVERYTHING
I TRY SEEMS USELESS...
Thank you for your time concerning this matter.
Answer: It's not the dilantin, but I really have no idea why resection of the tumor would cause you to loose weight.
Question: I had a hysterectomy on 7/22/99. I was taking Dilantin after my brain aneurism, but I hated the side effects. I stopped taking it in 1997. I hadn't had any seizures, until after surgery (the hysterectomy)
I had two that night. They put me on Dilantin, but now say I can't take the replacement hormones. I am now taking 12 Dilantin a day. I am trying to get an answer as to how those two things react with one
another. Please help me if you can. My doctor always seems to busy or hurried to have time to answer my questions.
Answer: For the life of me, I don't understand the logic. It does change the metabolism,but blood levels are all that one needs to follow this. By the way 12 Dilantin is a huge dosage. Have you had your blood levels checked?
Can OTC Headache Medications be
Taken with Dilantin [posted 12/10/98]
Question: My father is taking dilantin and sometimes having headaches and a fever.
Is tylenol safe to take or is it contraindicated?
Answer: Tylenol is safe in small doses.
Getting Off Dilantin [posted
Question: Someone I know was put on 300 mg Dilantin daily and
has been on it for approx 3 years. He had an aneurysm and they put him on it as as
"just in case" he had no seizure. Now no doctor will help him discontinue the
dilantin and he is attempting to discontinue it on his own, please give me any info you
can to help, thank you
Answer: If his EEG is normal, then just decrease
the dosage 100 mg a week or so. There should be no withdrawal syndrome, just a risk of
Dilantin for Insomnia [posted
Question: Have you ever heard of dilantin prescribed for
chronic insomnia (insomnia characteristics are constant arousal from sleep, lack of deep
sleep, and inability to return to sleep because of "over active" brain)?
Answer: Yes, but, uncommonly used-sometimes of
help with restless leg syndrome.
Dilantin Levels [posted 11/11/98]
Question: When level is to low possible side effects?
Answer: Usally a serum level of 10 is the lowest that we like to achieve to keep
seizures under control. The dosage to do this varies widely and one usually follows blood
levels with this drug.
Can Dilantin Cause My Rash?
Question: I have been taking Dilantin for 5 months, for the second time. The first
time, around 8 years ago, I developed a rash immediately and had to switch to another
antiseizure medication: Depakote. Recently, I had to switch from Depakote due to low
platelet count. I went on Dilantin, as Tegretol had not agreed with me either, and within
six weeks had pancreatitis, not explained by any other physical problem. I now have an
itchy rash and red hives all over me. I think it is the Dilantin but my doctor says it is
not possible since I was on it for 3 months with no rash. She will not change me from it
and has refered me to a dermatologist. What can I do and could it be the Dilantin, again?
If so, what else could I take?
Answer: Get another doctor, it is probably the dilantin. Have you tried
Question: I have been on 250mg of dilantin daily for 17 years. Three years ago I
started having some pain where my liver is, and the doctor found out that my enzymes were
high-- sgot 53, sgpt 112, and ggt 1052. They gave me a MRI but found nothing. Hepatitis
tests were negative. While they were doing all these tests the symptoms went away. I
attributed it at the time to exercising and better eating habits. Now recently I just have
had my bloodwork redone and the enzymes have gone up. The sgot 95, sgpt 142, ggt1098, and
alk.phos is 258. I have no symptoms and feel really good. I have a hard time pinpointing a
doctor. Should I go to a family doctor and a liver specialist? The liver specialist three
years ago said not to worry about my enzymes, and if the symptoms come back to go back to
him and he will possibly do a liver biopsy. What effect do you think dilantin has on this?
Answer: The only way to know is to either get the liver biopsy or to stop the
dilantin and switch to another seizure drug. Unfortunately, almost every drug has
potential liver toxicity listed as a side effect. I doubt that Dilantin would cause this
problem several years out, but a drug vacation(using another seizure drug) might answer
Question: My father is 63 years old. He is on Dilantin 300mg daily since a brain
surgery 8 years ago. During a routine blood test recently, his PSA level was 6.4ng/ml. He
usually needs to get up twice a night to urinate. His physician performed a rectal
examination and ultrasound and prescribed him Ofloxacin 200mg twice daily and Cardura 1mg
daily for 1 month. After 1 month, the PSA level dropped to 6.08ng/ml. He was then
prescribed Doxycycline 200mg twice a day and Cardura 1mg daily for another month. However,
after 4 days, my father developed serious nausea and vomiting and was hospitalized. A
gastroscopy was performed and subsequently found to be H Pylori positive. His PSA level
dropped to 4.7ng/ml.
Answer: When there is mild elevation of the PSA it could either be due to
hypertrophy, prostatitis or early cancer. Physicians will often treat men for prostatitis
and if there is a subsequent drop in PSA, it obviates further testing including biopsy. I
have done the same in my office on many occasions and it appears to have worked in your
father with the continued drop in PSA, he probably had a mild infection in the prostate
which was contributing to the elevated PSA. Doxycycline certainly can cause nausea,
ofloxacin less commonly so. Hard to know if his was due to the doxycycline or not
-certainly was time related. I would take Cardura based on his symptoms of outlet
obstruction; not based on the PSA. If he is getting up several times or having trouble
with a decreased stream then Cardura or Hytrin would be useful. If only to treat the PSA
then it will have little effect.(PS Doxycycline is one of the treatment drugs for H.
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