Diphenylhydantoin Control of Alcohol Withdrawal Seizures

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Abstract
Diphenylhydantoin (300 mg/day) or placebo was "blindly" administered for five days to 157 patients entering an alcoholism detoxification unit; all patients received sedative doses of chlordiazepoxide. All patients had a history of convulsions in adulthood. Eleven patients in the placebo-treated group but none in the diphenylhydantoin group had convulsions in the first 48 hours. Two patients had convulsions after withdrawal of active drug. Blood levels of diphenylhydantoin were determined in 18 alcoholics and in five normal subjects. Comparable blood levels (3μg/ml) were obtained in both groups after the first day and reached a plateau of 4μg/ml after the third. (JAMA230:1430-1432, 1974)