Granulocytopenia and death following the use of trimethadione.

TRIMETHADIONE N.N.R. ("tridione") has been used in man as an anticonvulsant drug since 1945. It has been found of greatest value in treatment of petit mal and psychomotor seizures. Toxic symptoms were reported by Lennox, 1 DeJong, 2 Richards and Everett, 3 Perlstein and Andelman 4 and Greaves, 5 but only 2 deaths following its use have been reported to date. These 2 deaths and the case recorded by Greaves are the only reported instances showing a toxic effect on the blood. Greaves's patient was a woman who took trimethadione in addition to phenobarbital and bromides. The last two drugs she had taken for years without ill effect. After only three weeks of trimethadione, her white blood cell count was 900, with 52 neutrophils, 42 lymphocytes and 6 mononuclear forms. Eight days after use of trimethadione was stopped, her white cell count returned to 5,000, but when the drug was