Effects of primidone: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Main Research Findings

Primidone is a commonly used anti-seizure medication. Many studies have investigated the effectiveness and safety of primidone. 21 analyzed the association between antiseizure medication (ASM) and the risk of urinary tract infections (UTI) in patients with epilepsy treated in general practices in Germany. 18 compared the safety of antiepileptic drugs (AEDs) on neurodevelopment of infants/children exposed in utero or during breast feeding. 9 quantified recent reports of DILI attributed to both older and newer generation ASMs and surveyed newly marketed ASMs for hepatotoxicity in a large post-marketing database. 11 discussed the reduction of neuronal hyperexcitability with modulation of T-type calcium channel or SK channel in essential tremor. 19 reviewed the literature and pharmacovigilance databases for pitch perception modifications due to antiepileptics. 24 evaluated pregabalin for essential tremor. 6 presented data on phenylethylmalonamide (PEMA) serum levels in patients treated with primidone and the effects of other antiepileptic drugs. 4 investigated ozone-based advanced oxidation processes for primidone removal in water using simulated solar radiation. 12 described pharmacologic considerations during the preoperative evaluation of neurologic patients. 15 evaluated prescribing patterns for potentially teratogenic AEDs and contraceptive use in women of childbearing ability with epilepsy. 3 reported a unique case of transiently elevated liver function test (LFT) values associated with concurrent use of dabigatran and primidone. 13 demonstrated that primidone blocks RIPK1-driven cell death and inflammation. 1 discussed the proliferation of the gingiva as an adverse effect of medications. 5 provided information and preliminary guidance related to the FDA Emergency Use Authorization for Paxlovid™ for the oral treatment of mild to moderate COVID-19 in adults and children. 10 addressed the current management of essential tremor. 26 measured the levels of 19 commonly occurring pharmaceutical and personal care products (PPCPs) in 8 vegetables irrigated with treated wastewater under field conditions. 14 provided insights into current and future pharmacotherapeutic approaches for essential tremor. reported a possible interaction of rivaroxaban with primidone in a patient with atrial fibrillation. 17 showed that Dupuytren, Ledderhose, and Peyronie diseases have been associated with antiepileptic drug use. 16 discussed epilepsy and breastfeeding. 25 aimed to synthesize emerging evidence for oral propranolol on subgroups of ET. examined the rate of onset of side effects in pediatric outpatients who received long-term monotherapy with phenobarbital (PB), primidone (PRM), phenytoin (PHT), carbamazepine (CBZ), or valproate (VPA). 23 evaluated a recirculating hydroponic bed bioreactor for removal of contaminants of emerging concern from tertiary-treated wastewater effluent. 8 conducted a synoptic survey of select wastewater-tracer compounds and the pesticide imidacloprid in Florida's ambient freshwaters. 7 reported a case of phenytoin induced dystonia. 20 systematically investigated the transport mechanisms of organic micropollutants (OMPs) in a fertilizer-drawn forward osmosis (FDFO) membrane process. studied the effects of withdrawing phenytoin, phenobarbital and primidone, and using carbamazepine as the primary anticonvulsant in 27 patients.

Benefits and Risks

Benefit Summary

Primidone has been shown to be effective in treating seizures. found that seizure control was essentially similar or somewhat improved in 20 out of 21 patients who received carbamazepine instead of sedative anticonvulsants, including primidone. 10 recommended primidone alongside propranolol for the treatment of essential tremor. 11 suggested that primidone might be effective in reducing neuronal hyperexcitability. 13 demonstrated that primidone blocks RIPK1-driven cell death and inflammation.

Risk Summary

Primidone carries some risk of side effects. 9 found that primidone could cause drug-induced liver injury (DILI). 17 reported that Dupuytren, Ledderhose, and Peyronie diseases have been associated with antiepileptic drug use, including primidone. 1 suggested that primidone might cause gingival hyperplasia. 5 stated that concomitant use of Paxlovid™ with primidone is contraindicated due to potential drug interactions.

Comparison of Studies

Similarities in Studies

Many studies have suggested that primidone is effective in treating seizures and essential tremor. It has also been commonly reported to have some risk of side effects. However, the specific risk and severity of side effects vary across studies.

Differences in Studies

Different studies have shown primidone to be most effective in treating different diseases or conditions, and have shown varying levels of risk for side effects. For example, found that seizure control was improved in 20 out of 21 patients who received carbamazepine instead of primidone. However, 10 recommended primidone alongside propranolol for the treatment of essential tremor. These studies show that primidone can be effective in treating different conditions.

Consistency and Contradictions in Results

There is both consistency and contradiction in the results regarding the effectiveness and safety of primidone. Some studies show that primidone is effective in treating certain conditions, while others have shown that it can cause side effects. These inconsistencies may be explained by factors such as study design, subject population, and dosage. Further research is needed to clarify these inconsistencies.

Considerations for Real-Life Applications

It is important to take primidone as directed by your doctor. Do not stop taking it or adjust the dosage without consulting your doctor. If you have any concerns about side effects, talk to your doctor. If you are pregnant or breastfeeding, consult with your doctor about the use of primidone. Primidone may interact with other medications, so it is important to talk to your doctor before taking it. 5 indicates that concurrent use of Paxlovid™ with primidone is contraindicated. Because primidone is metabolized by the liver, it's important to consult your doctor if you have liver problems.

Limitations of Current Research

There are limitations in the research on primidone. For example, many studies have a small sample size, which could limit the generalizability of their results. Additionally, variations in study design and methodology make it challenging to compare results across studies.

Future Research Directions

Further research on primidone is needed. In particular, studies investigating the long-term effects of primidone on effectiveness and safety are important. Research is also needed to develop methods for reducing side effects and to investigate interactions between primidone and other medications. Furthermore, research on the potential of primidone for treating inflammatory diseases, as suggested by 13 , is warranted.

Conclusion

Primidone is a potential treatment for seizures and essential tremor. However, it is associated with the risk of side effects. If you are considering taking primidone, consult with your doctor to determine if it is the right treatment for you. It is important to take primidone under the care of a healthcare professional.

Literature analysis of 26 papers
Positive Content
11
Neutral Content
6
Negative Content
9
Article Type
0
1
2
8
26
1.

[Medicaments and oral healthcare. Proliferation of the gingiva].

Author: de BaatC, ZweersP G M A, VissinkA

Gingival proliferation prevention
Gingival proliferation

This article discusses the adverse effect of medication and self-care products on the gingiva, specifically focusing on gingival proliferation. It highlights the drugs associated with this adverse effect, including anticonvulsants, calcineurin inhibitors, calcium channel blockers, and isotretinoin, and suggests potential preventive measures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Dutch

3.

Acute elevation of liver function test values following concomitant administration of dabigatran and primidone.

Author: CavinessLisa A, WassellKatelyn M, Howard-ThompsonAmanda

Liver function test elevation
Risk of thrombosis

A possible drug interaction between dabigatran and primidone was observed, leading to a transient elevation of liver function test (LFT) values in a patient.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Phenylethylmalonamide serum levels in patients treated with primidone and the effects of other antiepileptic drugs.

Author: StreeteJ M, BerryD J, PettitL I, NewberyJ E

The serum level of PEMA, a metabolite of primidone, is affected by the dose of primidone and the serum levels of other anticonvulsant drugs, especially phenobarbitone.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Phenytoin induced dystonia.

Author: AcarTarık, AlkanGülsüm, ÇaksenHüseyin, ErtekinBirsen, ErginMehmet, KoçakSedat, CanderBaşar

Dystonia treatment
Phenytoin-induced dystonia
Seizures

A 2.5-year-old male patient developed dystonia after being given phenytoin for tonic-clonic seizures. The dystonia was successfully treated with biperidene hydrochloride and primidone.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Drug-induced liver injury associated with antiseizure medications from the FDA Adverse Event Reporting System (FAERS).

Author: KamitakiBrad K, MinacapelliCarlos D, ZhangPengfei, WachukuChristopher, GuptaKapil, CatalanoCarolyn, RustgiVinod

Liver injury

This study investigated the risk of drug-induced liver injury (DILI) associated with antiseizure medications (ASMs). The results suggest that both older and newer generation ASMs can cause DILI.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Treatment of essential tremor: current status.

Author: SharmaSoumya, PandeySanjay

Tremor severity reduction
Functional disability
Side effects

This review covers the current management of essential tremor, focusing on different anatomical locations and treatment modalities, including pharmacotherapy, botulinum toxin injections, and surgical interventions. It also addresses a new subgroup, 'Essential tremor plus', which requires a tailored treatment approach.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Reduction of neuronal hyperexcitability with modulation of T-type calcium channel or SK channel in essential tremor.

Author: Wagle ShuklaAparna

Tremor treatment
DBS surgery risks

This review explores the pathophysiology of essential tremor, highlighting the importance of calcium channels and calcium-activated potassium channels in tremor oscillations. It also discusses current treatments for essential tremor, including medications, surgical therapies, and promising new pharmacological approaches targeting these channels.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Pharmacologic Considerations during the Preoperative Evaluation of Neurologic Patients.

Author: MabryChristian

Medication management
Neurologic disorders

This article discusses the perioperative management of patients with common neurologic disorders, such as Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Primidone blocks RIPK1-driven cell death and inflammation.

Author: RiebelingTheresa, JamalKunzah, WilsonRebecca, KolbrinkBenedikt, von Samson-HimmelstjernaFriedrich Alexander, MoerkeCaroline, Ramos GarciaLaura, DahlkeEileen, MichelsFriederike, LühderFred, SchunkDomagoj, DoldiPhilipp, TyczynskiBartosz, KribbenAndreas, FlühCharlotte, TheiligFranziska, KunzendorfUlrich, MeierPascal, KrautwaldStefan

Improved therapy

This study presents primidone, an FDA-approved antiepileptic drug, as a potent inhibitor of RIPK1 activation, a key mediator of regulated cell death and inflammation. The study also provides evidence for RIPK1 activation in the respiratory tract epithelium of patients with SARS-CoV-2 infection, suggesting that primidone may be a potential therapeutic agent for conditions of hyperinflammation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Brain circuits and neurochemical systems in essential tremor: insights into current and future pharmacotherapeutic approaches.

Author: SchaeferSara M, Vives RodriguezAna, LouisElan D

Essential tremor (ET) is a movement disorder with limited effective treatments. GABA neurotransmission is thought to play a role, and targeting specific GABA<sub>A</sub> receptor subtypes may be a promising strategy for future research.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Teratogenic medications and concurrent contraceptive use in women of childbearing ability with epilepsy.

Author: BhaktaJanki, BainbridgeJacquelyn, BorgeltLaura

Teratogenicity

This study investigates prescribing patterns for potentially teratogenic antiepileptic drugs (AEDs) and contraceptive use in women of childbearing age with epilepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

[Epilepsy and breastfeeding: from myth to reality].

Author: Cabo-LopezI, CannetiB, Puy-NunezA

Breastfeeding safety
AED incompatibility
Withdrawal symptoms

Very few antiepileptic drugs are incompatible with breastfeeding. The decision to breastfeed should be made on a case-by-case basis, taking into account the specific drug, dose, and individual patient factors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Spanish

17.

Dupuytren, Ledderhose, and Peyronie Diseases After Primidone Use For Essential Tremor.

Author: VasconcellosLuiz Felipe R, NassifDaniel, SpitzMariana

Fibrotic conditions

A 71-year-old man developed Dupuytren, Ledderhose, and Peyronie diseases after primidone use for essential tremor.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Comparative safety of antiepileptic drugs for neurological development in children exposed during pregnancy and breast feeding: a systematic review and network meta-analysis.

Author: VeronikiAreti Angeliki, RiosPatricia, CogoElise, StrausSharon E, FinkelsteinYaron, KealeyRyan, ReynenEmily, SoobiahCharlene, ThavornKednapa, HuttonBrian, HemmelgarnBrenda R, YazdiFatemeh, D'SouzaJennifer, MacDonaldHeather, TriccoAndrea C

Autism
Neurodevelopmental delay

Valproate alone or combined with another AED is associated with the greatest odds of adverse neurodevelopmental outcomes compared with control.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

[Pitch perception modification due to antiepileptics: A literature and pharmacovigilance databases review].

Author: Le DaréBrendan, TriquetLouise, DegremontAdeline, CharbonnelHoel, DefaultAnne, OsmontMarie-Noëlle, PicardSylvie, GentilhommeGuillaume, BellissantEric, ScailteuxLucie-Marie, PolardElisabeth

Pitch perception modification

This case report describes a patient with perfect pitch who experienced a loss of pitch perception after starting treatment with carbamazepine (CBZ) for epilepsy. This rare adverse effect resolved completely upon discontinuation of CBZ.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

24.

Pregabalin for essential tremor.

Author: BrunoElisa, NicolettiAlessandra, QuattrocchiGraziella, FilippiniGraziella, ColosimoCarlo, ZappiaMario

Essential tremor treatment
Adverse events
Ineffectiveness

This study discussed the need for alternative treatment options for essential tremor, considering the limitations of primidone and propranolol.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

25.

Oral propranolol for treatment of the subgroups of essential tremor: a systematic review and meta-analysis protocol.

Author: ZhangManyu, LiWei, HuLan, ChenLi, YangLiu, ZhangTian, ShenHui, PengYanan, GaoShijun, ChenZhibin, WangTan, ZhaoZhenqiang

Reduced tremor
Poor axial effect
Severity increases

Essential tremor (ET) is one of the most common movement disorders. While propranolol is a first-line treatment for ET, it has a poor effect on axial tremor symptoms like essential head tremor and voice tremor. This review aims to synthesize new data on the efficacy of propranolol in subgroups of ET based on the anatomical distribution of tremor.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

Treated wastewater irrigation: uptake of pharmaceutical and personal care products by common vegetables under field conditions.

Author: WuXiaoqin, ConkleJeremy L, ErnstFrederick, GanJay

Water reuse
Contamination

This study measured levels of 19 pharmaceuticals and personal care products (PPCPs) in 8 vegetables irrigated with treated wastewater. Results show that the accumulation of PPCPs in vegetables irrigated with treated wastewater was likely limited under field conditions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

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