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To the Editor:
—It has been shown that diphenylhydantoin affects the adrenal glands of certain laboratory animals (Staple, P. H.: Lancet1:1074, 1951; Woodbury, D. M.: J. Pharmacol. & Exper. Therap.105:46, 1952). In man diphenylhydantoin sodium (dilantin sodium®) may produce hirsutism, and there is some evidence (Staple, P. H.: Lancet1:372, 1952) that its anticonvulsant action may be modified by salicylates, which apparently stimulate adrenocortical activity. It would appear then that the results of Costa and Bonnycastle (J. A. M. A.149:1093 [July 19] 1952) include an effect due to diphenylhydantoin sodium as well as that due to epilepsy per se, since they state that their patients continued to receive their usual medication throughout the investigations.
Staple PH. ADRENOCORTICAL FUNCTION IN PATIENTS WITH CHRONIC EPILEPSY. JAMA. 1952;150(9):951. doi:10.1001/jama.1952.03680090115023