Treatment of Drug-Induced Psychosis with Diphenylhydantoin†

Abstract

Summary This paper introduces an alternative to the major tranquilizers in the treatment of acute psychotic breakdown following multiple drug abuse. All the patients described had been taking hallucinogenic drugs for over five years. Only three of several successfully treated cases are described. Two of these cases were followed by EEG recordings, which did not show any localized epileptiform activity. The response to diphenylhydantoin is described both clinically and as recorded by EEG. An initial two-week period is necessary in order that the effects of the drugs can be demonstrated clinically or on EEG tracing. It cannot be concluded from this that the antiepileptic drugs are the drugs of choice in drug-induced psychosis; but, diphenylhydantoin has shown dramatic effectiveness in these previously refractory cases. In view of the response, some abnormal cerebral discharge from an as yet undiscovered locus may be involved in the pathogenesis of drug-induced hallucinations.