Phenytoin for Post-Herpetic Pain.

Remy

Administrator
@Strike me lucky, here is a case study showing phenytoin eliminated post-herpetic pain, 100 mg tid.

Phenytoin is an old, cheap drug that works on the sodium channels and looks to have a lot of promise in treating MECFS symptoms in general including brain excitotoxicity. It's used in lower doses than what is commonly given for treatment of epilepsy.

Wonder if you could get your hands on some for a trial?
 

Remy

Administrator
@Remy Calms brain excitotixicity? I need me some of that!
From what I'm reading, it sounds like many of us could do with a trial of it...

Here's a quote describing some of the conditions it may show use in treating:

How Does Dilantin Work?
Dilantin calms electrical activity in the brain. That’s why it’s such a great anti-seizure medication. However, even if you don’t have a seizure disorder, you may be one of the millions of people who have “static” in these electrical impulses. This can lead to anxiety, depression and a host of other problems.
That’s where low-dose Dilantin comes in. Its effects on the nervous system can be likened to fine-tuning a radio. If you’re getting static—you can hear the music but there’s also a lot of irritating noise—adjusting the dial removes the noise and allows only music to come through. The sound is soothing and everyone is happy.
What Does Treatment With Dilantin Involve?

Dilantin uses require a prescription, so you will need to talk to your doctor. However, be prepared that he may not be willing to prescribe it for the conditions mentioned here.
Even though it is perfectly legal for physicians to do so (it’s called “off-label” drug use), medicine has become so tightly regulated that doctors sometimes tell patients they won’t risk their medical license by writing a prescription for other Dilantin uses.
That’s why I suggest you go to your physician armed with information. In addition to what you’ve read here, I strongly recommend the book The Story of a Remarkable Medicine, by Jack Dreyfus. It’s available, along with more information about Dilantin uses, at Remarkablemedicine.com.
What Conditions is Dilantin Good for?

  • Anxiety
  • Attention deficit hyperactivity disorder (ADHD)
  • Concentration problems
  • Claustrophobia
  • Depression
  • Dysphoria
  • Eating Disorders
  • Migraines
  • Obsessive-compulsive disorder
  • Restless leg syndrome
  • Temper tantrums
  • Tourette syndrome
 

Who Me?

Well-Known Member
Wow. and the key is, getting a doc to rx it. I didn't see, does this have to be followed so it won't liquify your organs? Lol
 

Remy

Administrator
I didn't see, does this have to be followed so it won't liquify your organs? Lol
If you mean, do you need labs to monitor your levels, no. It's used at lower doses than typically used for epilepsy and even at higher doses it had a remarkable safety profile.

It does seem to increase clearance of certain steroid hormones, like cortisol and estrogen though. So that is something for anyone with questionable adrenal/HPA axis issues to keep in mind. I'm not sure if it is a strong effect, like Rifampin, or a more mild effect though. I'm actually looking into that at the moment.
 

Who Me?

Well-Known Member
Just found this interesting. What docs check for B12 or folate deficiency?

'Before using this medication, tell your doctor or pharmacist your medical history, especially of: alcohol use, certain blood conditions (porphyria), diabetes, liver disease, lupus, folate or vitamin B-12 deficiency (megaloblastic anemia)."
 

Remy

Administrator
Just found this interesting. What docs check for B12 or folate deficiency?

'Before using this medication, tell your doctor or pharmacist your medical history, especially of: alcohol use, certain blood conditions (porphyria), diabetes, liver disease, lupus, folate or vitamin B-12 deficiency (megaloblastic anemia)."
That's another good point...phenytoin does seem to have the ability to cause folate deficiency and it is recommended to take supplemental folate along with it. There are several mechanisms whereby this interaction may occur, from decreasing the intracellular pH to inhibiting the enzymes that split folate into the absorbable form.

I do not know if these interactions are clinically significant at the low levels we are discussing here though.
 

Remy

Administrator
From what I've been reading, either too much or too little can have side effects.

The recommendation on a Lyme forum was to start with 50 mg once a day and keep adding until you max out on the benefit. My understanding is that this may be as little as 50 mg or as much as 300 mg.

It also says in the book that it can be taken daily or as needed. I would assume that a low dose taken intermittently would be the best way to avoid any problematic side effects upon withdrawal. It should be noted that they recommend a slow taper but don't actually mention a withdrawal syndrome.
 

Who Me?

Well-Known Member
I think with anything that affects the brain you have to start low and slow. And even if they don't mention withdrawal I'd never cold turkey.
 

Who Me?

Well-Known Member
Also lyrica causes weight gain so maybe this doesn't have that issue? I look at a lyrica capsule and start eating.
 

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