Comparison of the effectiveness of phenobarbital, mephobarbital, primidone, diphenylhydantoin, ethotoin, metharbital, and methylphenylethylhydantoin in motor seizures

Abstract

Forty‐four patients with focal brain damage and epilepsy were given phenobarbital, mephobarbital, primidone, diphenylhydantoin, ethotoin, metharbital, methylphenylethylhydantoin, and blank on a double blind basis as replacement for their usual anticonvulsant medications. The number of seizures observed provided a score which was used to determine drug effectiveness. The results indicate that the patients differed with regard to the severity of epilepsy, their response to medication and dose, and their response during 5 days of study. With effective doses of medication, the seizure scores increased more slowly than when ineffective doses were given. With all of the treatments except the blank and the smaller doses of diphenylhydantoin and ethotoin, there was an inverse relationship between dose and seizure scores. The doses of phenobarbital, diphenylhydantoin, metharbital, methylphenylethylhydantoin, mephobarbital, and primidone which were calculated to be equally effective were, respectively, 30, 200, 110, 112, 128, and 93 mg. Doses of 70 mg. diphenylhydantoin and 470 mg. ethotoin appeared to lower the seizure scores equally.