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1 October 1994 | Volume 121 Issue 7 | Page 550
Dr. Siddiqui is correct that osteomalacia is the common metabolic bone problem resulting from phenytoin therapy. This may occur in as many as one third of patients, but the effects are more common in polytherapy than in monotherapy. It also may be seen with other antiepileptic drugs that induce hepatic metabolism. However, the changes are minor during the first 2 years of monotherapy with phenytoin [1-4].
1. Levy R, Mattson R, Meldrum B, Henry JK, Dryfuss FE, eds. Phenytoin: Toxicity in Antiepileptic Drugs. 3rd ed. New York: Raven Press Ltd.; 1989:241-55.
2. Dellaportas DI, Galbraith AW, Laundy M, Reynolds EH, Marshall WJ, Chanarin I. Chronic toxicity in epileptic patients receiving single drug treatment. Br Med J. 1982; 85:409-10.
3. Gough H, Goggin T, Bissessar A, Baker M, Crowley M, Callaghan N. A comparative study of the relative influence of different anticonvulsant drugs, UV exposure and diet on vitamin D and calcium metabolism in out-patients with epilepsy. Q J Med. 1986; 230:569-77.
4. Hahn TJ. Bone complications of anticonvulsants. Drugs. 1976; 12:201-11. About Letters
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