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Clinical Neuropharmacology 1986
Review
Topics: Adrenergic beta-Antagonists; Ethanol; Humans; Phenobarbital; Primidone; Propranolol; Tremor
PubMed: 2885088
DOI: No ID Found -
Movement Disorders : Official Journal... Mar 2002Early side effects are common when primidone is used to treat essential tremor, with as many as one-third of patients failing to tolerate the tablets. Lower doses can be... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
Early side effects are common when primidone is used to treat essential tremor, with as many as one-third of patients failing to tolerate the tablets. Lower doses can be prescribed initially using a suspension formulation. We suspected suspension initiation would result in fewer early side effects, allow better acclimatization, and improve compliance. Forty patients with essential tremor were randomized to begin primidone treatment using either 2.5 mg doses in the suspension form or 25 mg doses in the tablet form. Doses gradually increased over 3 weeks to 150 mg/day. This was a double-blind, double-dummy trial. Medication cessation due to side effects was designated the primary end-point. Four patients in the suspension group and two in the tablet group dropped out due to early side effects, resulting in a relative risk of 1.9 (95% confidence interval 0.4 to 9.2). Side effects in the first 48 hours of treatment were equally common, affecting seven subjects in each group. Treatment benefits were the same in both groups. We concluded that use of a very low initial dose and a graduated titration schedule in suspension formulation did not appear to improve primidone tolerability. If anything, compliance tended to be worse when compared with the tablet formulation, though the study was under-powered to reject the null hypothesis of equivalence.
Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Essential Tremor; Female; Humans; Male; Middle Aged; Primidone
PubMed: 11921128
DOI: 10.1002/mds.10083 -
Epilepsy & Behavior : E&B Oct 2003
Topics: Aged; Alzheimer Disease; Anticonvulsants; Antipsychotic Agents; Dementia; Epilepsy; Female; Humans; Primidone
PubMed: 14527505
DOI: 10.1016/j.yebeh.2003.07.010 -
European Journal of Clinical... 1984The pharmacokinetics of primidone (PRM) after oral administration of a single 500 mg dose was studied in 7 patients with acute viral hepatitis and 7 healthy control...
The pharmacokinetics of primidone (PRM) after oral administration of a single 500 mg dose was studied in 7 patients with acute viral hepatitis and 7 healthy control subjects. The elimination half-life and the apparent clearance of unchanged PRM in the patients were 18.0 +/- 3.1 h and 42 +/- 14 ml X h-1 X kg-1, respectively (mean +/- SD) and did not differ significantly from the values in the controls (half-life 17.0 +/- 2.4 h; clearance 35 +/- 8 ml X h-1 X kg-1). The metabolite phenylethylmalonamide (PEMA) was detected in the serum of all normal subjects within 2-24 h. By contrast, serum levels of this metabolite were undetectable (less than 2 mumol/1) in all but one of the patients. Serum levels of phenobarbital (PB) remained below the limit of detection (less than 2 mumol/1) in all subjects. The findings indicate that accumulation of PRM with its attendant toxicity is unlikely to occur in epileptic patients who develop acute viral hepatitis, despite evidence that the metabolism of the drug is affected by this condition. The possibility of impaired conversion to PB and its implications are discussed.
Topics: Acute Disease; Adult; Biotransformation; Female; Hepatitis, Viral, Human; Humans; Kinetics; Male; Middle Aged; Phenobarbital; Primidone
PubMed: 6519155
DOI: 10.1007/BF00549596 -
Journal of Neurology, Neurosurgery, and... Jan 1986The effects of placebo, propranolol and primidone were compared in 14 patients with essential tremor in a double blind, randomised, crossover study. Objective measures... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
The effects of placebo, propranolol and primidone were compared in 14 patients with essential tremor in a double blind, randomised, crossover study. Objective measures of tremor were obtained using an accelerometer with subsequent spectral analysis. Both propranolol (p less than 0.01) and primidone (p less than 0.01) gave significant improvement in tremor, but there was no significant difference in improvement between these drugs. Patients with higher dominant frequencies of tremor tended to respond to both drugs, while those with lower frequencies improved on one or other. There was no differential effect between the drugs with the frequency of tremor.
Topics: Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Primidone; Propranolol; Random Allocation; Tremor
PubMed: 3514797
DOI: 10.1136/jnnp.49.1.64 -
Annals of Neurology May 1979The pharmacokinetics and efficacy of the anticonvulsant primidone (PRM) and its active metabolites, phenobarbital (PB) and phenylethylmalonamide (PEMA), were studied... (Comparative Study)
Comparative Study
The pharmacokinetics and efficacy of the anticonvulsant primidone (PRM) and its active metabolites, phenobarbital (PB) and phenylethylmalonamide (PEMA), were studied after single-dose administration in mice. The half-life of PB is twice that of PRM and PEMA. The plasma/brain ratios provide evidence of poor penetration of PRM into brain. The results support our findings of negligible or absent PRM concentrations in the brains of patients on primidone therapy who were undergoing surgery for intractable epilepsy. The anticonvulsant properties of PRM, PB, and PEMA against maximal electroshock in mice were also studied with the use of the metabolic inhibitor SKF 525A. The half-life, potency, peak anticonvulsant effect, and effective dose curves of these compounds indicate that the anticonvulsant effect of short-term oral PRM administration in mice is from derived PB.
Topics: Animals; Biotransformation; Brain Chemistry; Dose-Response Relationship, Drug; Female; Mice; Phenobarbital; Phenylethylmalonamide; Primidone; Seizures; Time Factors
PubMed: 464548
DOI: 10.1002/ana.410050512 -
Epilepsia Oct 2000We report on the effect that pretreating patients with phenobarbital has on averting adverse events when primidone is introduced. (Clinical Trial)
Clinical Trial Comparative Study
PURPOSE
We report on the effect that pretreating patients with phenobarbital has on averting adverse events when primidone is introduced.
METHODS
Thirty patients with intractable partial epilepsy were pretreated with phenobarbital before starting primidone. Therapy with primidone was started at a dosage of 500 mg/day, and the phenobarbital was stopped. The primidone dose was then increased by 125 to 250 mg every 3 weeks until adverse events or a seizure-free state was reached. All previous antiepileptic medications were tapered down to yield a primidone monotherapy regimen.
RESULTS
Twenty-six patients (87%) tolerated the introduction of primidone with minimal or no adverse events. Only one patient had to discontinue primidone during the initial 4 weeks because of severe dizziness. This was the only patient in whom primidone monotherapy could not be reached because of adverse events. Three other patients experienced dizziness severe enough to interfere with their activities. This symptom disappeared in two patients after the dose was lowered; in the other patient, primidone was stopped and phenobarbital was restarted for another 4 days. No symptoms recurred when primidone was reintroduced on the fifth day.
CONCLUSIONS
Pretreatment with phenobarbital can minimize the occurrence of intolerable adverse events associated with the introduction of primidone.
Topics: Adolescent; Adult; Aged; Ambulatory Care; Child; Child, Preschool; Dizziness; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Tolerance; Epilepsies, Partial; Female; Follow-Up Studies; Hospitalization; Humans; Male; Middle Aged; Phenobarbital; Premedication; Primidone; Treatment Outcome
PubMed: 11051127
DOI: 10.1111/j.1528-1157.2000.tb04610.x -
The Journal of Nervous and Mental... Jul 1976Prior to the release of carbamazepine for the treatment of patients with psychomotor and grand mal seizures, primidone was regarded as the drug of choice for these... (Comparative Study)
Comparative Study
Prior to the release of carbamazepine for the treatment of patients with psychomotor and grand mal seizures, primidone was regarded as the drug of choice for these disorders, especially when combined with diphenylhydantoin (DPH). It was, therefore, of interest to compare the effectiveness of carbamazepine against primidone when added to a therapeutic dose of DPH. Forty-five patients completed a 6-month study with each patient serving as his own control. The patients were initially stabilized on therapeutic doses of DPH and one of the test compounds, while all other medications were withdrawn. After 3 months of treatment, they were transferred onto the other drug for a second 3-month period. Extensive laboratory testing, including anticonvulsant levels, electroencephalograms, and neuropsychological evaluations, was performed. For the most part, the patients remained on outpatient status, returning for reports of seizure frequency, side effects, and laboratory studies every 14 days. The study was conducted in a single blind fashion by the treating neurologists; double blind by the electroencephalographer and psychologists. The results indicated that the two drugs did not differ in their effectiveness on seizure control. There were somewhat more side effects--none serious--with carbamazepine than with primidone. The EEG showed increased fast activity with primidone and increased theta activity with carbamazepine. There was no difference in regard to decrease of electroencephalographic seizure discharges. The patients showed more impairment on a repeatable neuropsychological test battery with primidone than with carbamazepine, and they also showed an increase on the psychopathic deviate scale of the Minnesota Multiphasic Inventory. Depressive feelings, when present, lessened while under treatment with carbamazepine. The results suggest that patients with the seizure types under consideration and who do not respond to DPH alone or to a DPH-phenobarbital combination can be placed on either carbamazepine or primidone while phenobarbital is discontinued. A patient who is intellectually and emotionally intact with no past history of behavioral disturbances may do better on primidone than carbamazepine, because this drug gives fewer side effects. On the other hand, those patients who have a past history of emotional and/or intellectual disturbances may profit more from carbamazepine.
Topics: Adolescent; Adult; Carbamazepine; Epilepsy, Temporal Lobe; Epilepsy, Tonic-Clonic; Female; Humans; Male; Middle Aged; Primidone
PubMed: 819630
DOI: 10.1097/00005053-197607000-00006 -
Annals of Internal Medicine Jul 1980We studied a family with the long QT syndrome. The initial case was in a patient who presented with seizures, ventricular fibrillation, and syncope. After a trial of...
We studied a family with the long QT syndrome. The initial case was in a patient who presented with seizures, ventricular fibrillation, and syncope. After a trial of conventional modalities of treatment including left stellate ganglionectomy, primidone (Mysoline) therapy was initiated. This drug has been successful in suppressing ventricular arrhythmias and shortening the QT interval over a 2-year follow-up period. Two additional family members with QT prolongation have been treated with primidone. During an 8-month follow-up, electrocardiographic and Holter recordings showed shortening of the QT interval.
Topics: Adolescent; Adult; Arrhythmias, Cardiac; Death, Sudden; Electrocardiography; Female; Follow-Up Studies; Heart Ventricles; Humans; Male; Primidone; Seizures; Syndrome
PubMed: 7396315
DOI: 10.7326/0003-4819-93-1-53 -
Archives of Neurology Jan 1966
Clinical Trial Comparative Study
Topics: Clinical Trials as Topic; Epilepsy; Female; Humans; Male; Phenobarbital; Phenytoin; Primidone
PubMed: 5320823
DOI: 10.1001/archneur.1966.00470070035004