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Clarence E. McDanal, Jr., MD; William M. Bolman, MD

JAMA. 1975;231(10):1063.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

A PATIENT had a delayed idiosyncratic psychosis to diphenylhydantoin sodium. We have not found another case in the medical literature that described this type of reaction to diphenylhydantoin with supportive blood level data. Stevens¹ mentioned four reports of epileptic patients with bizarre, psychotic signs and symptoms who were treated with changes in anticonvulsant medication, neuroleptic drugs, and environment. Unfortunately, no anticonvulsant blood levels were mentioned. The side effects of diphenylhydantoin fall into two categories: dose dependency or individual hypersensitivity or idiosyncratic response. Sparberg² described the medical complications of diphenylhydantoin therapy and concluded that they were diagnostically confusing.

Report of a Case

A 30-year-old mother of three children had had seizures since she was 12 years old but none in the past four years. She received anticonvulsant medications, mephobarbital, 32 mg four times daily, and diphenylhydantoin sodium, 100 mg four times daily. The patient faithfully took the medication; she . . . [Full Text PDF of this Article]

Author Affiliations
From the University of Hawaii School of Medicine (Dr. Bolman), and Leahi Hospital, Honolulu. Dr. McDanal is a Fellow in Child Psychiatry at the University of Hawaii, Honolulu.

Footnotes
The approved nonproprietary name of diphenylhydantoin will be phenytoin when USP 19 becomes official.

Reprint requests to University of Hawaii, School of Medicine, Leahi Hospital, 3675 Kilauea Ave, Honolulu, HI 96816 (Dr. McDanal).

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