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October 25, 1971

Diphenylhydantoin in the Treatment of Alcohol Withdrawal

JAMA. 1971;218(4):598. doi:10.1001/jama.1971.03190170076035

To the Editor.—  In full support of Finer's letter (217:211,1971) advocating diphenylhydantoin in alcohol withdrawal, I would like to call attention to the statement in AMA Drug Evaluations (Chicago, American Medical Assoc, 1971) that the hydantoins are usually of little value in treating the major motor seizures in the withdrawal syndrome from alcohol and other drugs. Several other articles beside that of Gessner (216:887, 1971) have also negated its use in this area by commission or direct discredit. Though Finer states that it is "well established and recorded in standard textbooks of pharmacology" and its use advised for suspected convulsions in a standard psychiatry text, I find the use of diphenylhydantoin totally absent from two standard textbooks of medicine in sections on alcoholism treatment.Having had contact with too many patients with a history of convulsions and delirium tremens due often to misinformed or injudicious attempts to "shake

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