The doctors, Jan M. Keppel Hesselink and David Kopsky, from the Institute for Neuropathic Pain in Amsterdam, summarized their findings on the benefits of a 10% topical cream with phenytoin as the active ingredient as follows.
“We, therefore, developed a new topical cream based on 5% and 10% phenytoin and described three successfully treated patients suffering from neuropathic pain.”
“All patients were refractory[resistant] to a number of other analgesics.”
“In all patients, phenytoin cream was effective in reducing pain completely, without any side effects, and the tolerability was excellent.”
“The onset of action of the phenytoin creams was within 30 minutes.”
Looking further into the details of the study, the subjects applied the cream on their body several times a day in a maintenance program.
Case #1: diabetic neuropathic pain
“The pain reduction appeared within 5 minutes after application and was maintained for at least 12 hours. The patient applied the phenytoin 10% cream two times daily during a period of 3 months.”
Case #2: chemotherapy-induced polyneuropathy
“The patient applied the cream three times daily during a period of 2 months.”
Case #3: chemotherapy-induced polyneuropathy
“The patient applied the cream two times daily during 1 month.”
The pain from the neuropathic conditions returned once the daily applications ended. However the cream provided temporary relief for the patients cited above.
Another paper titled, Dilantin (Phenytoin) for Pain Management in Multiple Sclerosis, reviewed the traditional use of phenytoin for MS patients living in a state of constant pain.
“Dilantin (phenytoin) is a hydantoin anticonvulsant that is commonly used for the management of epileptic seizures.”
“In MS patients, it is used for pain management to reduce painful sensations caused by demyelination in the sensory pathways in the brain and spinal cord.”
However the topical cream avoids the many harmful side effects which present themselves when the drug travels throughout the entire body.
Common Dilantin side effects include nausea, vomiting, constipation, tremors, slurred speech, loss of balance or coordination, rash, headache, confusion, dizziness, nervousness and/or sleep disorders.
Phenytoin isn’t sold over-the-counter, and must be prescribed by a licensed doctor. The article “Topical Pain Creams for Management of Acute, Chronic, and Neuropathic Pain” described the advantages and the challenges of overcoming pain from neurological conditions with phenytoin.
“Neuropathic pain is an extremely difficult type of pain to manage. The symptoms experienced by the patient with neuropathic pain differ from those experienced by patients with acute pain. Neuropathic pain usually fails to respond to standard analgesic interventions. Opioids may provide a degree of relief, but only at doses impractical for what may become lifelong therapy. People with neuropathic pain can experience anything from mild discomfort to excruciating torture.”