Balance and Coordination

Hi,

Are the following the names of the medications you have listed, I think your spelling is off a little.

Mesasal
Phenobarbital
Dilantin

A cursory check showed no drug interactions concerning gait or balance.

Of the dugs listed as ototoxic, potentially harmful to the ears and balance, I only saw Phenytoin.

"Other medications may cause temporary ototoxicity:

Anticonvulsants, such as phenytoin (Dilantin®) and carbamazepine (Tegretol®)
Antidepressants, such as clomipramine (Anafranil®) and amoxapine (Asendin®)
Antihypertensives, such as labetolol (Trandate® or Normodyne®) and enalapril (Vasotec®)
Loop diuretics, such as bumetanide (Bumex®) and furosemide (Lasix®)
Pain relievers, such as aspirin
Quinine (chloroquine, quinidine)"

www.lvhn.org/conditions_treatments/brain_and_nerves/balance_problems/ototoxicity/learn_about_ototoxicity

Drugs are metabolized by various mechanisms, liver and kidneys being common routes. Phenytoin is a medication that can have its metabolizing rate significantly effected by other medications, even over-the-counter medications. Because of this, you need to be careful with other medications that would be added to what you're taking now, prescription or over-the-counter. They have the potential to increase the level of phenytoin in your blood. This may worsen the effects of the phenytoin in terms of balance. Always consult with your doctor or pharmacist with medication questions.

Lastly, consulting a good ENT may be of value, to be sure there is not an underlying process occurring, and the ENT may be able to make suggestions on controlling your problem.

I take Phenytoin 300 mg twice a day, I've taken it for over 20 years. I've not had problems with it with the exception of some neuropathy.

I wouldn't take Dilantin or any of those stupid drugs if they were the last thing on earth, zombieville, greedville. Want no part of it.

Hi RanMan,

For the drugs you listed I did not see interactions, I wasn't suggesting that, but anything new can unexpectedly be a problem.

Phenytoin saturates at some point, so that a slight increase in the dosage can produce a disproportionate increase in blood levels. It's not likely that you're at that point, but early toxicity shows as tremors and eye movements (nystagmus). See the link and excerpt below.

Another aspect of Dilantin is it is ordinarily metabolized quickly, but select drugs and substances can interfere with that rapid metabolism, so if you took some new medication or supplement that interfered with that metabolism, you can actually end up with high blood levels since the other drug prevented the Dilantin from being metabolized as normal. That's why it's important to check with your doctor or pharmacist, even before using over-the-counter drugs.

Lastly, Dilantin depletes Folic Acid, but when I take anything but the mildest Folic Acid supplements, say 100% of the Recommended Daily Allowance, I get break through seizures.

You may want to be sure your neurologist requests a blood test that is comprehensive enough to show electrolytes and vitamin levels. If B-12 works with Folic Acid, and Folic Acid, or the B-Series Vitamins are low, that may contribute to your problems as well. "DO NOT" start to take these substances without your doctor's approval. My doctor gave me B-12 pills, I had a lot more energy, but I also had significant seizure breakthrough.

Do the blood tests first and ask your Neurologist for guidance if you need to take supplements.

Also, see an ENT if you have not already done so.

labtestsonline.org/understanding/conditions/vitaminb12/

www.mayoclinic.org/diseases-conditions/vitamin-deficiency-anemia/basics/tests-diagnosis/con-20019550

www.nlm.nih.gov/medlineplus/ency/article/003037.htm

"ACQUIRED NYSTAGMUS

The most common cause of acquired nystagmus is certain drugs or medication. Phenytoin (Dilantin) - an antiseizure medication, excessive alcohol, or any sedating medicine can impair the labyrinth's function.

Other causes include:

Head injury from motor vehicle accidents
Inner ear disorders such as labyrinthitis or Meniere's disease
Stroke
Thiamine or vitamin B12 deficiency"

Actually, it gave me seizure breakthrough. Same with Folic Acid.

Phenytoin causes decreased levels of Folic Acid and adding Folic Acid supplementation causes decreased blood levels of Phenytoin. It's suggested that Folic Acid supplementation be co-administered when Phenytoin therapy is initiated, and both Folic Acid and Phenytoin taken together as long as Phenytoin is being used.

www.ncbi.nlm.nih.gov/pubmed/8520091

I've had success recently by using Ensure once a day, Carnation Instant Breakfast once a day, a few different brands of vitamin water, and eating more fruits and vegetables that have levels of vitamins I'm looking for. This is done throughout the day. All the things I use each supply less than or near 100% of of the Recommended Daily Allowance of various vitamins, I avoid Energy drinks since many have many times the RDA.

There are limited side effects, though I didn't see headaches mentioned, how much are you using.