From the FDA Drug Label
Like other antiepileptic drugs, primidone may cause suicidal thoughts or actions in a very small number of people, about 1 in 500 Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: ... feeling agitated or restless
Yes, primidone can cause agitation, as indicated by the symptom "feeling agitated or restless" in the drug label 1.
From the Research
Yes, primidone can cause agitation as a side effect, and it is essential to monitor patients for behavioral changes, especially when starting treatment or increasing the dose. Primidone, an anticonvulsant medication commonly used to treat seizures and essential tremor, affects the central nervous system and can lead to behavioral changes including agitation, irritability, nervousness, and mood changes in some patients. These effects are more likely to occur when starting treatment or after dose increases. Elderly patients may be particularly susceptible to these side effects. Primidone works by decreasing abnormal electrical activity in the brain, but this mechanism can also affect mood regulation and behavior. If you experience agitation while taking primidone, don't stop the medication abruptly, but contact your healthcare provider promptly. They may adjust your dosage, recommend taking the medication at different times, or consider alternative treatments. Starting with a low dose and gradually increasing it can sometimes help minimize these side effects. Some studies have investigated the management of agitation in various contexts, such as the use of benzodiazepines and antipsychotics 2, lurasidone for agitation in schizophrenia 3, and the potential for aripiprazole to cause agitation 4. However, these studies do not directly address primidone's role in causing agitation. The efficacy and safety of primidone have been studied in different patient populations, including those with essential tremor 5 and neonates with seizures 6, but these studies do not provide direct evidence on primidone-induced agitation. Given the potential for primidone to cause agitation, it is crucial to closely monitor patients for signs of agitation and adjust treatment as needed to minimize this side effect and ensure the best possible outcome in terms of morbidity, mortality, and quality of life.