From the Guidelines
Primidone is used to reduce the recurrence rate of febrile seizures in children, typically administered in doses of 15 to 20 mg/kg per day. This is based on the findings of a study published in the journal Pediatrics in 2008 1. The study suggests that primidone itself may be active in preventing seizure recurrence, even at derived phenobarbital levels below therapeutic range.
Some key points to consider when using primidone for febrile seizures include:
- The dosage of 15 to 20 mg/kg per day has been shown to be effective in reducing the recurrence rate of febrile seizures 1
- Adverse effects of primidone include behavioral disturbances, irritability, and sleep disturbances, similar to those associated with phenobarbital 1
- It is essential to monitor patients for these potential side effects and adjust the treatment plan as needed
In terms of its mechanism of action, primidone is metabolized in the body to phenobarbital, which contributes to its therapeutic effect. However, the study suggests that primidone itself may have a role in preventing seizure recurrence, even at low levels of phenobarbital 1.
Overall, primidone is a viable treatment option for reducing the recurrence rate of febrile seizures in children, when used at the recommended dosage and with careful monitoring for potential side effects.
From the FDA Drug Label
Primidone, used alone or concomitantly with other anticonvulsants, is indicated in the control of grand mal, psychomotor, and focal epileptic seizures. Primidone tablets are prescription medicine used alone or with other medicines to treat people with:
- generalized tonic-clonic (grand mal) seizures
- complex partial (psychomotor) seizures
- partial (focal) epileptic seizures
Primidone is used to treat epileptic seizures, including grand mal, psychomotor, and focal seizures 2 2.
From the Research
Uses of Primidone
- Primidone is used in the management of epilepsy, effective against all types of seizures (except for absences) 3
- It is also used for the treatment of essential tremor, with studies showing it to be an effective agent 4, 5
- Primidone can be used for seizures refractory to standard antiepileptic drugs, particularly in neonates and young infants 6
- The drug has been compared to propranolol in the suppression of essential tremor, with primidone being a possible alternative when beta-blockers are contraindicated 5
Specific Conditions Treated with Primidone
- Partial seizures
- Generalized tonic-clonic seizures
- Essential tremor
- Seizures in neonates and young infants