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Journal of Neurology, Neurosurgery, and... Sep 1985Uncontrolled clinical studies have suggested that primidone may be effective in reducing essential tremor thus providing a valuable alternative to beta-adrenoreceptor... (Clinical Trial)
Clinical Trial
Uncontrolled clinical studies have suggested that primidone may be effective in reducing essential tremor thus providing a valuable alternative to beta-adrenoreceptor antagonists which are currently the drugs of first choice. A double blind, placebo controlled trial of primidone in essential tremor of the hands and head was carried out using both clinical and objective methods of assessment. Primidone was significantly superior to placebo in reducing the magnitude of hand tremor, its efficacy being comparable to that of propranolol. In two patients tremor was reduced to non-symptomatic levels, an effect rarely seen with propranolol. No consistent attenuation of head tremor was found. There was no correlation between serum primidone or derived phenobarbitone concentrations and the reduction of hand tremor. An acute toxic reaction to an initial small dose (62.5 mg) of primidone was seen in six of 22 patients.
Topics: Adolescent; Adult; Aged; Ataxia; Clinical Trials as Topic; Double-Blind Method; Female; Hand; Head; Humans; Male; Middle Aged; Nausea; Primidone; Tremor; Vomiting
PubMed: 3900296
DOI: 10.1136/jnnp.48.9.911 -
Epilepsy & Behavior : E&B May 2005Depressive symptoms are common in epilepsy. To determine associations between depression and demographic, clinical, and pharmacological factors among epileptic patients,... (Clinical Trial)
Clinical Trial Comparative Study
Depressive symptoms are common in epilepsy. To determine associations between depression and demographic, clinical, and pharmacological factors among epileptic patients, we conducted a cross-sectional survey. We evaluated 241 epileptic outpatients at a neurological center in a 6-month period. Depressive syndrome was diagnosed when both the Montgomery-Asberg Scale and the Beck Depression Inventory were rated above the standard cutoff points. Bivariate and multivariate analyses were performed to assess the differences between depressed and nondepressed patients with respect to demographic, clinical, and pharmacological features. Depressive syndrome was diagnosed in 42.7% of patients (n=103). Factors associated in the bivariate analysis were: cryptogenic etiology, posttraumatic epilepsy, use of primidone, and inadequate seizure control. After logistic regression, inadequate seizure control (OR 3.08, 95% CI 1.40-6.77, P=0.005) and use of primidone (OR 4.08, 95% CI 2.09-7.98; P<0.001) remained significantly associated. Depression was common and associated with inadequate seizure control and use of primidone.
Topics: Adult; Analysis of Variance; Anticonvulsants; Cross-Sectional Studies; Demography; Depression; Epilepsy; Female; Humans; Logistic Models; Male; Personality Inventory; Primidone; Psychiatric Status Rating Scales; Self-Assessment; Sickness Impact Profile; Surveys and Questionnaires
PubMed: 15820351
DOI: 10.1016/j.yebeh.2005.01.016 -
Archives of Disease in Childhood Apr 1969
Topics: Barbiturates; Child, Preschool; Female; Humans; Primidone
PubMed: 5779436
DOI: 10.1136/adc.44.234.282 -
Neurology Oct 1982The effect of nicotinamide on the conversion of primidone to phenobarbital was studied in mice and in three epileptic patients. In mice, 200 mg per kilogram of...
The effect of nicotinamide on the conversion of primidone to phenobarbital was studied in mice and in three epileptic patients. In mice, 200 mg per kilogram of nicotinamide increased the half-life of primidone by 47.6%, and the conversion to phenobarbital and phenylethylmalonamide was decreased by 32.4% and 14.5%, respectively. Nicotinamide also decreased the conversion of primidone to phenobarbital in patients. The dose of nicotinamide correlated directly with the primidone-phenobarbital ratio (r = 0.861, p less than 0.01). Nicotinamide also increased carbamazepine levels in two patients treated with this drug. The data demonstrate that nicotinamide inhibits metabolism of primidone in mice and metabolism of primidone and carbamazepine in humans. This probably occurs by inhibition of cytochrome P-450 by nicotinamide.
Topics: Animals; Carbamazepine; Child; Child, Preschool; Drug Interactions; Drug Therapy, Combination; Epilepsy; Female; Half-Life; Humans; Infant; Male; Mice; Mice, Inbred Strains; Niacinamide; Phenobarbital; Phenylethylmalonamide; Primidone
PubMed: 6214728
DOI: 10.1212/wnl.32.10.1122 -
Annals of Ophthalmology Jun 1989A 37-year-old man with a history of seizures developed periodic alternating nystagmus (PAN) along with other signs of primidone/phenobarbital toxicity. The PAN gradually...
A 37-year-old man with a history of seizures developed periodic alternating nystagmus (PAN) along with other signs of primidone/phenobarbital toxicity. The PAN gradually diminished in cycle length and intensity, finally resolving with gradual discontinuation of the drugs.
Topics: Adult; Electronystagmography; Eye Movements; Humans; Male; Nystagmus, Pathologic; Periodicity; Phenobarbital; Primidone; Visual Acuity
PubMed: 2764437
DOI: No ID Found -
Clinical Pharmacology and Therapeutics Mar 1981Primidone (PRM) kinetics was examined in two groups of adult seizure patients: (1) 10 newly diagnosed in whom only PRM was used, the monotherapy (MT) group, and (2) nine...
Primidone (PRM) kinetics was examined in two groups of adult seizure patients: (1) 10 newly diagnosed in whom only PRM was used, the monotherapy (MT) group, and (2) nine in whom PRM was added to other antiepileptics, the combination therapy (CT) group. Time-concentration data were obtained after an initial dose of 250 mg and during subsequent steady-state periods. PRM elimination was slower (p less than 0.05) after the initial dose in MT patients (half-life (t 1/2) = 15.2 hr, apparent clearance = 35 ml/hr/kg) than in CT patients (t 1/2 = 8.3 hr, clearance = 51 ml/hr/kg). PRM metabolites, phenobarbital and phenylethylmalonamide, appeared much earlier in CT patients. Continued PRM exposure in MT patients was accompanied by an increase in apparent clearance in three of seven patients, but no change in four of seven. In four CT patients in whom other antiepileptics were withdrawn there was a decrease in apparent clearance (61.4 to 29.9 ml/hr/kg) no rates in the range of MT patients. PRM kinetics is influenced by concurrent antiepileptic drugs and by duration of PRM therapy.
Topics: Adolescent; Adult; Aged; Drug Therapy, Combination; Female; Humans; Kinetics; Male; Metabolic Clearance Rate; Middle Aged; Phenobarbital; Phenylethylmalonamide; Primidone; Seizures; Time Factors
PubMed: 7471611
DOI: 10.1038/clpt.1981.55 -
Clinical Neuropharmacology Feb 1990The long-term efficacy of primidone (375-750 mg/day) in essential tremor was evaluated prospectively in 11 patients who had shown a favorable response to 4-week...
The long-term efficacy of primidone (375-750 mg/day) in essential tremor was evaluated prospectively in 11 patients who had shown a favorable response to 4-week treatment with the drug under placebo-controlled conditions. On accelerometric evaluation, the magnitude of tremor after 3, 6, and 12 months on primidone was still significantly reduced compared with the initial placebo period. After discontinuation of primidone, tremor amplitude reverted to the placebo levels. Some loss of efficacy during long-term administration, however, was suggested by the results of self-assessment, physician's assessment, and performance tests. Three patients discontinued prematurely the drug because the sedative effects outweighed the potential therapeutic benefit. Side effects (especially drowsiness and sedation) were common at 4 weeks and 3 months but tended to subside thereafter. It is concluded that primidone retains at least part of its tremorolytic effect for up to 1 year, although the overall clinical benefit is limited in most patients.
Topics: Aged; Anxiety; Computers; Female; Humans; Male; Middle Aged; Phenobarbital; Primidone; Prospective Studies; Tremor
PubMed: 2306749
DOI: 10.1097/00002826-199002000-00007 -
Neurology Feb 1973
Topics: Ataxia; Chromatography, Gas; Drug Tolerance; Epilepsy; Humans; Nystagmus, Pathologic; Phenobarbital; Phenytoin; Primidone
PubMed: 4734509
DOI: 10.1212/wnl.23.2.145 -
Spectrochimica Acta. Part A, Molecular... May 2013The solid phase FTIR and FT-Raman spectra of primidone were recorded in the regions 4000-400 cm(-1) and 4000-100 cm(-1), respectively. The vibrational spectra were...
The solid phase FTIR and FT-Raman spectra of primidone were recorded in the regions 4000-400 cm(-1) and 4000-100 cm(-1), respectively. The vibrational spectra were analysed and the observed fundamentals were assigned and analysed. The experimental wavenumbers were compared with the theoretical scaled vibrational wavenumbers determined by DFT methods. The Raman intensities were also determined with B3LYP/6-31G(d,p) method. The total electron density and molecular electrostatic potential surface of the molecule were constructed by using B3LYP/6-311++G(d,p) method to display electrostatic potential (electron+nuclei) distribution. The HOMO and LUMO energies were measured. Natural bond orbital analysis of primidone has been performed to indicate the presence of intramolecular charge transfer. The (1)H and (13)C NMR spectra were recorded and the chemical shifts of the molecule were calculated.
Topics: Anticonvulsants; Hydrogen Bonding; Magnetic Resonance Spectroscopy; Models, Molecular; Primidone; Quantum Theory; Spectrophotometry, Ultraviolet; Spectroscopy, Fourier Transform Infrared; Spectrum Analysis, Raman
PubMed: 23542519
DOI: 10.1016/j.saa.2013.03.025 -
British Journal of Clinical Pharmacology Oct 19901. The pharmacokinetics and metabolism of primidone at steady-state were studied in 10 elderly patients aged 70-81 years and eight control subjects aged 18-26 years. 2.... (Comparative Study)
Comparative Study
1. The pharmacokinetics and metabolism of primidone at steady-state were studied in 10 elderly patients aged 70-81 years and eight control subjects aged 18-26 years. 2. Primidone half-lives and clearance values (mean +/- s.d.) were similar in the elderly and in the young (12.1 +/- 4.6 vs 14.7 +/- 3.5 h and 34.8 +/- 9.0 vs 33.2 +/- 7.2 ml h-1 kg-1 respectively. 3. The serum concentrations of the metabolites phenylethylmalonamide (PEMA) and phenobarbitone relative to those of parent drug were higher in the elderly than in the young, the difference being significant (P less than 0.01) in the case of PEMA. 4. The renal clearances of primidone, phenobarbitone and PEMA were moderately decreased in the elderly but this reduction was statistically significant only for PEMA. Elderly patients excreted a reduced proportion of unchanged primidone and an increased proportion of PEMA in urine. 5. Ageing is associated with a greater accumulation of PEMA, which is unlikely to have a major clinical significance.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aging; Biotransformation; Chromatography, High Pressure Liquid; Epilepsy; Female; Half-Life; Humans; Male; Phenobarbital; Phenylethylmalonamide; Primidone; Tremor
PubMed: 2291873
DOI: 10.1111/j.1365-2125.1990.tb03820.x