primidone / Generic mfg. - LARVOL DELTA

When Constipation Becomes a Renal Emergency: Stercoral Proctocolitis With Fecaloma-Induced Bilateral Hydroureteronephrosis and Obstructive Acute Kidney Injury (ACG 2026) - "Her medications included hydroxyzine, carbamazepine, mirtazapine, primidone, pregabalin, deutetrabenazine, and venlafaxine, contributing to a high anticholinergic burden. Massive fecal impaction causing stercoral proctocolitis and obstructive uropathy. Figure Footnote: The distended colon compresses the distal ureters resulting in bilateral hydroureteronephrosis (arrows)."

Acute Kidney Injury • Bipolar Disorder • Cardiovascular • CNS Disorders • Constipation • Endocrine Disorders • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Hypotension • Infectious Disease • Inflammatory Bowel Disease • Movement Disorders • Nephrology • Parkinson's Disease • Renal Disease

Developmental and/or Epileptic Encephalopathy with Spike-Wave Activation in Sleep: From Thalamocortical Mechanisms to Precision Therapy. (PubMed, Children (Basel)) - "Emerging etiology-directed therapies, including L-serine for selected GRIN loss-of-function variants and primidone for TRPM3-related disease, illustrate a broader transition from syndrome-based to precision management. However, no pharmacological therapy is specifically approved for D/EE-SWAS, long-term neurodevelopmental morbidity remains common, and adequately powered trials using standardized EEG and neurocognitive outcomes are urgently needed."

Journal • Review • CNS Disorders • Epilepsy • TRPM3

Improvement of Multifactorial Tremor in Klinefelter Syndrome With Testosterone Replacement Therapy. (PubMed, Case Rep Endocrinol) - "A man in his 50s with long-standing learning difficulties and schizophrenia currently treated with clozapine presented with gynaecomastia and a new right testicular mass. He was noted to have a severe tremor interfering with activities of daily living treated with combination levodopa + benserazide, primidone and topiramate...Tremor in Klinefelter syndrome is often refractory to anti-tremor medical therapy; however, as reported in this case, testosterone therapy may improve tremor in Klinefelter syndrome. It is rare for TRT to significantly improve tremor as reported in this case."

Journal • CNS Disorders • Genetic Disorders • Movement Disorders • Psychiatry • Schizophrenia

Memantine modulates TRPM3-associated glutamatergic signaling via vGLUT2 in a mouse model of obsessive-compulsive disorder. (PubMed, Eur J Pharmacol) - "Treatment with memantine, primidone, or their combination significantly attenuated OCD-like behaviors, reduced TRPM3 and vGLUT2 immunoreactivity, and IL-6 concentration. These findings support a novel TRPM3-vGLUT2-NMDA signaling axis in OCD and suggest memantine and primidone as promising candidates for targeted, mechanism-based therapy."

Journal • Preclinical • CNS Disorders • Inflammation • Mental Retardation • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • IL6 • TRPM3

The effectiveness of adding on or switching antiseizure medications after the first fails to control focal epilepsy: A systematic review of randomized controlled trials. (PubMed, Epileptic Disord) - "Valproate showed higher responder rates than primidone (RR 1.52, 95% CI 1.01-2.28) in an add-on trial, while lamotrigine had a lower responder rate than valproate (RR 0.74, 95% CI 0.55-0.99) in one trial. In a switch strategy, lamotrigine showed lower treatment failure rates than valproate (RR 0.61; 95% CI 0.45-0.83) and fewer adverse effects than carbamazepine and valproate...The small number of trials, short follow-up for endpoints, and methodological heterogeneity across trials constrain interpretation and clinical applicability. Leveraging observational data with causal inference methods, alongside pragmatic trials evaluating machine-learning-guided ASM selections, is needed to address this evidence gap and improve seizure management."

Journal • Review • CNS Disorders • Epilepsy

Intranasal 6-OHDA Induces TRPM3-mediated Neuroinflammation in the pVTA: A Preclinical Early-stage Parkinson's Disease Model. (PubMed, Mol Neurobiol) - "Intraperitoneal (i.p.) treatment of TRPM3 inhibitor primidone (2.5, 5, and 10 mg/kg) significantly reversed these alterations, and standard pramipexole (3 mg/kg, i.p.) also reduced behavioral deficits. Overall, the intranasal 6-OHDA model reproduces key features of early-stage PD, including non-motor deficits, dopaminergic dysfunction, TRPM3-associated neuroinflammation, and impaired neuroplasticity, providing a simple and clinically relevant platform for therapeutic evaluation."

Journal • Preclinical • CNS Disorders • Cognitive Disorders • Depression • Inflammation • Mood Disorders • Movement Disorders • Parkinson's Disease • Psychiatry • IL1B • TRPM3

Epidemiology and treatment of patients with Essential Tremor: A retrospective cohort analysis in the United Kingdom. (PubMed, Neuroepidemiology) - "This study provides UK-based evidence on ET epidemiology, clinical features, and treatments. Despite lower epidemiological estimates attributable to the requirement for two confirmed diagnoses - a methodological choice prioritising diagnostic specificity in a condition that is frequently over-diagnosed - ET burden and unmet needs remain substantial."

Journal • Retrospective data • Cardiovascular • Diabetes • Essential Tremor • Hypertension • Metabolic Disorders • Movement Disorders • Pain

Reduced Efficacy of Eplerenone in Primary Hyperaldosteronism with Concomitant Use of Primidone (ENDO 2026) - "Eplerenone, an off-label drug, is used to treat primary hyperaldosteronism in patients who cannot tolerate standard therapy spironolactone due to its side effects like gynecomastia...He was being considered for switching to Finerenone due to suboptimal response with eplerenone... This case highlights the importance of being aware of CYP3A4-inducing medications in patients on mineralocorticoid receptor antagonists, especially when patients have exhibited unsatisfactory clinical outcomes."

Clinical • Cardiovascular • Endocrine Disorders • Essential Tremor • Hypertension • Movement Disorders • CYP3A4

Shaken Will: Intention Tremor as a Contributor to Suicidality — A Literature Review and Case Illustration (APA 2026) - "Reports note benefit from non-invasive strategies (tendon vibration, cooling, weighting, positioning) and pharmacologic trials (botulinum toxin, levetiracetam, primidone, topiramate) which are not widely adopted. Neurobiological and social factors create a multifactorial risk profile supporting interdisciplinary management in psychiatry. Future research should establish evidence-based guidelines for integrating interdisciplinary care in this vulnerable population."

Clinical • Review • CNS Disorders • Depression • Dystonia • Essential Tremor • Mood Disorders • Movement Disorders • Suicidal Ideation

Refractory seizures as a manifestation of anti-epileptic drug induced hypocalcemia and vitamin D deficiency. (PubMed, JCEM Case Rep) - "Enzyme-inducing antiepileptic drugs (EIAEDs) such as carbamazepine, phenytoin, phenobarbital, and primidone are used in the management of epilepsy and can alter hepatic enzymes of the cytochrome P450 (CYP450) system. Further evaluation revealed low 25-hydroxy vitamin D, suggesting significant hypocalcemia and vitamin D deficiency culminating in super-refractory focal status epilepticus due to chronic EIAED use. This case underscores the need to maintain a high index of suspicion for metabolic disturbances in patients on long-term EIAED therapy with regular monitoring of vitamin D and calcium levels to prevent complications."

Journal • CNS Disorders • Endocrine Disorders • Epilepsy • Metabolic Disorders • Ophthalmology

Refined kinetic analyses of micropollutant degradation by UV-AOPs incorporating dynamic oxidant decay. (PubMed, J Hazard Mater) - "For instance, in a secondary sedimentation effluent at a photon fluence of 1.47 × 10⁻2 einstein m-2, the relative error of model-predicted primidone removal by UV/free chlorine reduced from 98.3% to 12.6%. Additionally, relative deviation framework identified scenarios that violate the constant k' assumption, providing guidance for the selection of kinetic analysis methods. These advancements provide a robust foundation for rigorous experimental design and kinetic interpretation, offering potential value for more rational and energy-efficient operation of UV-AOPs."

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Developmental and/or epileptic encephalopathy with spike-and-wave activation in sleep: Pathophysiological insights and treatment options. (PubMed, Epilepsia) - "Precision medicine approaches, including N-methyl-D-aspartate receptor-targeted therapies for GRIN variants and channel-specific treatments such as primidone for TRPM3 gain of function, offer promising avenues toward disease modification. Epilepsy surgery should be considered early in children with unilateral structural etiologies, where it can provide substantial neurodevelopmental benefit. Future priorities include standardized outcome measures, integration of sleep-based biomarkers, refinement of steroid protocols, and international collaborative trials to improve long-term neurodevelopmental outcomes in this vulnerable population."

Journal • Review • CNS Disorders • Epilepsy • Pediatrics • Sleep Disorder • GRIN2A • TRPM3

Resolution of Essential Tremor Following a Pontine Ischemic Stroke: A Case Report (AAN 2026) - "Her preexisting bilateral essential tremor had been refractory to primidone and had significantly impaired her ability to perform fine motor tasks such as writing and feeding herself...The findings suggest that small pontine lesions may disrupt components of the cerebello-thalamo-cortical pathway involved in essential tremor pathophysiology. Further neuroimaging and neurophysiological studies are warranted to elucidate the mechanisms by which brainstem lesions can modulate tremor activity."

Case report • Clinical • Ataxia • Cardiovascular • Essential Tremor • Ischemic stroke • Movement Disorders • Musculoskeletal Diseases • Orthopedics

Novel Biallelic AOPEP Variants Presenting with Unilateral Wing Beating Tremor in Active Duty Military Member (AAN 2026) - "A physical exam revealed an immediate right arm high amplitude postural tremor with dystonic posturing at the wrist, worse in the wing-beating position that was not distractible, without parkinsonism features...His tremor was refractory to trihexyphenidyl, propranolol, topiramate, primidone, and a carbidopa/levodopa challenge...Biallelic mutations are known to cause dystonia 31 which we suspect has manifested with a novel combination of heterozygous autosomal recessive variants, with one allele likely inherited and the other arising de novo. Additionally, the dystonic tremor seen in this case expands the phenotype of dystonia 31 which has not been described yet."

CNS Disorders • Dystonia • Movement Disorders • Parkinson's Disease

Comparative Efficacy of Acupuncture Therapy in Primary Essential Tremor: A Network Meta-Analysis and Systematic Review. (PubMed, Healthcare (Basel)) - "This network meta-analysis demonstrates that acupuncture-related interventions are effective and safe for treating essential tremor. However, caution is warranted in interpreting these findings due to methodological limitations in the included randomized controlled trials (small sample sizes, lack of blinding, inadequate allocation concealment), sparse data for some interventions, and the concentration of studies within China, which limits their generalizability. Despite these limitations, acupuncture offers a valuable non-pharmacological treatment option for patients with poor medication tolerance. Future large-scale, multicenter trials with rigorous designs are needed to validate these findings."

Journal • Retrospective data • Review • Essential Tremor • Movement Disorders

A Systematic Review of Clinically Significant Drug-Drug Interactions With Phenobarbital and Primidone. (PubMed, Pharmacotherapy) - "Data suggest that PB does lead to clinically significant DDIs in multiple classes of medications. Future areas of research include focused evaluations on clinical outcomes, as well as studies specifically evaluating single high-dose PB and impact on DDI outcomes."

Journal • Review • CNS Disorders • Epilepsy • Pediatrics

TRPM3 mediates spontaneous pain and mechanical allodynia in a mouse model of chronic orofacial neuropathy. (PubMed, Cell Rep Med) - "Two structurally distinct TRPM3 antagonists, primidone and isosakuranetin, effectively reverse spontaneous pain and mechanical allodynia, whereas mavatrep, a potent TRPV1 antagonist, is without analgesic effect. These data indicate that TRPM3 is essential for ongoing pain and allodynia following trigeminal nerve injury, making it a potential target for treating trigeminally mediated neuropathic pain."

Journal • Preclinical • Neuralgia • Pain • TRPM3 • TRPV1

Enteric virus and pharmaceutical and personal care product attenuation in a bench-scale ozone-soil aquifer treatment process. (PubMed, Sci Total Environ) - "Ozonation of characteristically recalcitrant compounds such as sulfamethoxazole, meprobamate, N-N-diethyl-m-toluamide and primidone increased the collective O3-SAT removal compared with SAT alone. Desorption of carbamazepine previously adsorbed to below detection was observed, driven by historical concentrations in soil or modifications to the concentration gradient. These results highlight O3-SAT as a promising enhancement for improving robustness of water reuse treatment systems under a range of operational scenarios."

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Unique Case of GABRA4-Related Neurodevelopmental Disorder with a Novel Frameshift Variant (ACMG 2026) - "He showed early developmental regression in motor and speech skills and was on lamotrigine for a long period...Outcome and Follow-Up The patient's tremor improved with primidone...These findings provide crucial evidence to support reclassification of this novel variant and underscore the utility of genome sequencing in diagnosing patients with complex NDDs. Further reporting of individuals with similar variants is essential to delineate the clinical spectrum and establish definitive genotype-phenotype corelations."

Clinical • Neurodevelopmental • Autism Spectrum Disorder • CNS Disorders • Depression • Developmental Disorders • Diabetes • Epilepsy • Genetic Disorders • Gestational Diabetes • Gynecology • Mental Retardation • Metabolic Disorders • Movement Disorders • Psychiatry • Schizophrenia

Efficacy and Safety of Primidone in the Treatment of Amyotrophic Lateral Sclerosis: A Single-Center Retrospective Study (ChiCTR) - P=N/A | N=30 | Not yet recruiting | Sponsor: Yichang Central People's Hospital; Yichang Central People's Hospital

New trial • Amyotrophic Lateral Sclerosis • CNS Disorders

The Impact of Primidone Treatment on Fluid Metabolomics in Patients with Amyotrophic Lateral Sclerosis: A Retrospective Study (ChiCTR) - P=N/A | N=212 | Not yet recruiting | Sponsor: Yichang Central People's Hospital; Yichang Central People's Hospital

New trial • Amyotrophic Lateral Sclerosis • CNS Disorders • CXCL8

Study on the Efficacy and Safety of Primidone in Adult with Amyotrophic Lateral Sclerosis — A Randomized, Double-blind, Placebo-controlled Clinical Trial (ChiCTR) - P=N/A | N=288 | Not yet recruiting | Sponsor: Yichang Central People's Hospital; Yichang Central People's Hospital

New trial • Amyotrophic Lateral Sclerosis • CNS Disorders • CXCL8

Update on Medical Treatments for Essential Tremor: An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review. (PubMed, Mov Disord) - "Current evidence from RCTs with at least 1 month of follow-up is insufficient to confidently support the efficacy of available medical treatments for ET. There is a need for longer, higher-quality clinical trials to improve treatment recommendations and guide decision-making for clinicians and patients with ET."

Journal • Review • CNS Disorders • Essential Tremor • Movement Disorders • Parkinson's Disease

Echoes of Childhood Trauma: A Rare Case of Holmes Tremor With Neuroanatomic Imaging and Video Evidence. (PubMed, Cureus) - "Misdiagnosed initially as a conversion reaction, she later received a diagnosis of "essential tremor with Parkinsonian features" and was treated with primidone and intermittent carbidopa-levodopa. Holmes tremor, characterized by low-frequency (2-4 Hz) high-amplitude tremors at rest, with movement, or in posture, is distinct from essential and cerebellar tremors. This case illustrates the rarity of this particular tremor, highlights its distinction from other tremors, and demonstrates potential treatments, including levodopa, thalamotomy, and deep brain stimulation."

Journal • Video • Ataxia • CNS Disorders • Essential Tremor • Movement Disorders • Parkinson's Disease

Degradation method for the antiepileptic drug primidone in water using a hybrid high-frequency ultrasound and photo-Fenton process. (PubMed, MethodsX) - "After 75 min of treatment, the sono-photo-Fenton method showed better degradation efficiency (93 %) than the sono-Fenton (83 %) and sonolysis (62 %) methods. Finally, the effectiveness of the degradation method by sono-photo-Fenton was tested in simulated pharmaceutical wastewater, degrading 72 % of primidone at 75 min of treatment, indicating matrix effect plays a role in the degradation (which could be a potential application of ultrasound hybridized with the photo-Fenton process).•Three ultrasound-based treatment methods were applied to degrade primidone in water.•The sono-photo-Fenton method degraded 93 % of primidone during 75 min of treatment.•The matrix influence on primidone degradation by sono-photo-Fenton was evaluated."

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