primidone / Generic mfg. - LARVOL DELTA

Primidone: a clinically promising candidate for the treatment of psoriasis. (PubMed, Cell Death Discov) - "Based on these findings, we now reveal both a preventive and, more importantly, a therapeutic effect of primidone in the imiquimod (IMQ)-induced psoriasis-like inflammation model. This allows us to unequivocally identify RIPK1 as a therapeutic target in the treatment of inflammatory disorders, including psoriasis. Given that newly developed RIPK1 inhibitors have shown very limited success in clinical trials for inflammatory and neurological diseases in recent years, and that none of these inhibitors has yet reached clinical utilization, our data strongly recommend a clinical study to evaluate the already approved drug primidone for the treatment of patients suffering from psoriasis within the context of drug repurposing."

Journal • Review • CNS Disorders • Dermatology • Epilepsy • Immunology • Inflammation • Psoriasis • RIPK1

Modified QuEChERS for antiepileptic drugs detection in forensic toxicology. (PubMed, MethodsX) - "This study aims to concurrently assess the blood concentrations of antiepileptic drugs including phenobarbital, carbamazepine, primidone, phenytoin in post-mortem samples through the application modified QuEChERS extraction. The equation of linear calibration curve was obtained with regression coefficient > 0.99. Detection limits were in the range of 0.21-0.38 ng/mL.•This method is inexpensive and fast for determination of antiepileptic drugs in serum•This method has high thought of sample determination.•This method is green chemistry method."

Journal

Trends in prescription of new antiseizure medications in a single center in Latin America: evidence of clinical practice. (PubMed, Front Neurol) - "Of 1,192 prescriptions, third-generation ASMs accounted for the majority (53.7%), led by levetiracetam (24.1%), lamotrigine (14%), and lacosamide (6%). Second-generation ASMs comprised 42.4%, including valproate (21.5%), carbamazepine (11.3%), and clonazepam (5.5%). First-generation ASMs were less frequently prescribed (3.9%), primarily phenytoin (2.3%), primidone (1.0%), and phenobarbital (0.3%)...First-generation ASMs are still prescribed but at lower rates. These results provide insights into changing prescription practices and access to newer medications, informing future research and hospital policies."

Journal • CNS Disorders • Epilepsy

Inhibition of TRPM3 by Primidone Provides a Potential Therapeutic Method for Adenomyosis Management (WCE 2025) - "Our study is to reveal the expression profile of transient receptor potential channels (TRPs) in adenomyosis patients and evaluate the effects of TRPM3 inhibitor, primidone on tamoxifen-induced adenomyosis mice Materials and Methods Eutopic endometrium from adenomyosis patients (n=20) was collected and subjected to mRNA analysis of TRPs. Further verification was conducted on the expression of CHIL1, COL9A2, PSMC3IP, NEIL3, and SPC24, which play an important role in multiple pathological mechanisms, including inflammation, tissue remodeling, injury, DNA repair and cell mitosis. Conclusion The expression profile of TRPs varies significantly in adenomyosis patients, and the TRPM3 inhibitor primidone may provide a potential therapeutic method for adenomyosis management."

Endometriosis • Inflammation • Pain • Women's Health • NEIL3 • PSMC3IP • TRPA1 • TRPM3 • TRPV1

Optimization and development of a green high performance liquid chromatography method for determination of 8 anti-epileptic drugs and 2 active metabolites in human serum assessed using AGREE, AGREEprep, GAPI and BAGI. (PubMed, Anal Methods) - "The aim of this study was to optimize and develop a green high-performance liquid chromatography (HPLC) method suitable for simultaneous detection of 8 AEDs and 2 active metabolites including primidone (PRM), lamotrigine (LTG), carbamazepine (CBZ) and its active metabolite 10,11-epoxide (CBZE), oxcarbazepine (OXC) and its active metabolite 10,11-dihydro-10-hydroxyl carbamazepine (MHD), phenobarbital (PHB), eslicarbazepine acetate (ESLA), clonazepam (CZP) and diazepam (DZP) in human serum. The results of greenness assessment showed that the proposed method was ecofriendly. Finally, the validated method was successfully applied in the analysis of real serum samples."

Journal • CNS Disorders • Epilepsy

A magnetic poly (methacrylic acid-co-ethylene glycol dimethacrylate) copolymer for extraction of anticonvulsants from saliva followed by high performance liquid chromatography analysis. (PubMed, J Chromatogr B Analyt Technol Biomed Life Sci) - "Therefore, this study describes the synthesis of a magnetic poly (methacrylic acid-co-ethylene glycol dimethacrylate) copolymer (M-CP) and its use in magnetic dispersive solid phase extraction of primidone (PMR), phenobarbital (PB), phenytoin (PHT), and carbamazepine (CB) from saliva, followed by their determination by high performance liquid-chromatography. The limits of detection ranged from 0.48 to 1.30 mg L-1, while the limits of quantification were lower than the therapeutic levels of each drug, being suitable for the method application. The developed method is simple, fast, and requires few amounts of saliva, sorbent, and solvents, being a good alternative for the therapeutic biomonitoring of anticonvulsants in saliva samples."

Journal • CNS Disorders • Epilepsy

Investigating potential molecular mechanisms of antiepileptic drug-induced depression through network toxicology and molecular docking. (PubMed, Neuroscience) - "After identifying eight AEDs (Topiramate, Zonisamide, Phenobarbital, Primidone, Levetiracetam, Gabapentin, Tiagabine, and Perampanel) potentially associated with depression via a literature review, further analysis integrating drug and disease target databases revealed 25 targets relevant to AED-induced depression. In vitro experiments demonstrated that Zonisamide treatment elevated the expression and activity of MAOA protein in the prefrontal cortex of mice, which may influence monoaminergic neurotransmission through MAO pathway regulation, potentially leading to depression. Collectively, this integrated approach elucidates the mechanisms underlying AED-induced depression, thereby establishing a foundation for future therapeutic strategies."

Journal • CNS Disorders • Depression • Epilepsy • Mood Disorders • Psychiatry

Does pre-treatment with phenobarbital prevent the acute intolerance to primidone in patients with essential tremor? (PubMed, Neurol Sci) - "Pre-treatment with PB minimizes the occurrence of acute intolerance to PMD, most likely due to functional cross-tolerance. The option of receiving low-dose PB for a short period before starting on PMD should be offered to ET patients in whom PMD therapy is indicated. PB-pre-treatment should also be considered whenever occurrence of acute intolerance prevented continuation of PMD therapy."

Journal • Ataxia • Essential Tremor • Movement Disorders

Approach to childhood tremors: Insights from a pediatric neurologist. (PubMed, Eur J Paediatr Neurol) - "Childhood tremor is a common clinical condition with diverse etiologies, where treatable causes, especially vitamin deficiencies, play a significant role. Functional impairments, such as difficulty in drinking water, using a spoon, and writing, may serve as key predictors for initiating first-line anti-tremor therapy. Propranolol remains an effective therapeutic option for essential tremor in children."

Journal • Endocrine Disorders • Essential Tremor • Movement Disorders • Pediatrics

Severe tremors induced by tiletamine e-cigarette and alcohol use: a case report. (PubMed, Front Psychiatry) - "Therefore, primidone was added and gradually titrated to 50 mg/day...As we gradually replaced diazepam with lorazepam, the patient insisted on discharge...The successful management of tremors with a combination of neuroinhibitory therapies suggested an effective strategy for complex cases. Further studies are needed to better understand the long-term impacts and risks of tiletamine dependence."

Journal • Addiction (Opioid and Alcohol) • Anesthesia • CNS Disorders • Movement Disorders • Psychiatry

Opsoclonus-Myoclonus Syndrome with Prominent Tremor: A Unique Presentation of West Nile Virus (P2-10.001). (PubMed, Neurology) - "His tremor greatly improved with primidone and he was discharged to acute rehab...An immediate family member of Dr. Thon has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genentech."

Journal • Ataxia • CNS Disorders • Critical care • Gastrointestinal Disorder • Immunology • Infectious Disease • Movement Disorders • Oncology • Pain • Pulmonary Disease

Inhibition of TRPM3 by Primidone Provides a Potential Therapeutic Method for Adenomyosis Management. (PubMed, Drug Des Devel Ther) - "To test the expression profile of transient receptor potential channels (TRPs) in adenomyosis patients and evaluate the effects of primidone on tamoxifen-induced adenomyosis mice...From 10 weeks after birth, primidone (2 mg/kg/d) and atosiban (1 mg/kg/d) were given separately to adenomyotic mice by intraperitoneal injection for 3 weeks...Forty-seven DEGSSs were identifieSd after primidone treatment, and bioinformatics analysis predicted that they were enriched in the cell cycle and cell division. The expression profile of TRP channels varies significantly in adenomyosis patients, and primidone may provide a potential therapeutic method for adenomyosis management."

Journal • Endometriosis • Gynecology • Musculoskeletal Pain • Pain • Women's Health • TRPA1 • TRPM3 • TRPV1

Manic Switch Associated With Primidone in a Patient Treated for Essential Tremor. (PubMed, J Clin Psychopharmacol) - No abstract available

Journal • CNS Disorders • Essential Tremor • Movement Disorders

Clinical and Molecular Landscape of Amyotrophic Lateral Sclerosis Patients with OPTN Variants from Turkey and Possible Therapeutic Response to Inhibation of RIPK1 (AAN 2025) - "The clinical association of OPTN exhibits allelic heterogeneity. Repurposing primidone, an FDA approved RIPK inhibitor may have beneficial effects in OPTN-ALS."

Clinical • Amyotrophic Lateral Sclerosis • CNS Disorders • Epilepsy • Glaucoma • Ophthalmology • GFAP • OPTN • RIPK1

Opsoclonus-Myoclonus Syndrome with Prominent Tremor: A Unique Presentation of West Nile Virus (AAN 2025) - "His tremor greatly improved with primidone and he was discharged to acute rehab. WNV should be considered in patients who present with OMS, especially if there are associated infectious symptoms. A prominent tremor may also be present, and the condition may respond to immunologic treatment such as plasmapheresis and steroids."

Ataxia • CNS Disorders • Gastrointestinal Disorder • Immunology • Infectious Disease • Movement Disorders • Oncology • Pain • Pulmonary Disease

Non-invasive Cervical Vagus Nerve Stimulation Improves Digital Spiral Tests in Essential Tremor: An Open Label Pilot Study (AAN 2025) - "Medical treatments including propranolol and primidone are limited by dose-related side effects. Treatment with non-invasive cVNS improved previously validated metrics for the analysis of Archimedes spirals. This pilot study highlights the potential benefit of non-invasive cVNS in ET."

Clinical • Non-invasive • Essential Tremor • Movement Disorders

Tumor, Tear, Tremor: Holmes Tremor Can Present as an Atypical Sign of Intracranial Hypotension After Olfactory Groove Tumor Resection (AAN 2025) - "Despite treatment with levetiracetam, benzodiazepines, and primidone, symptoms persisted. Distortion of midbrain anatomy secondary to intracranial hypotension (IH) explains the development of Holmes tremor. Focal seizures although are a reasonable differential however repeat MRI Brain can be a reasonable and diagnostic step. It is therefore essential to include differential diagnosis of movement disorders in patients presenting with symptoms of IH."

Brain Cancer • CNS Disorders • CNS Tumor • Epilepsy • Fatigue • Hypotension • Meningioma • Movement Disorders • Oncology • Parkinson's Disease • Solid Tumor

Progressive Unilateral Tremor Associated with Large Confluent Perirolandic Juxtacortical Lesions in MS (ACTRIMS Forum 2025) - "Progressive unilateral tremor with contralateral perirolandic lesion is a novel phenotype of progressive MS and the pathogenesis may represent critical demyelinating lesions disrupting the cerebello-thalamo-cortical circuitry."

CNS Disorders • Movement Disorders • Multiple Sclerosis

Developing an Ecotoxicological Classification for Frequently Used Drugs in Primary Care. (PubMed, Int J Environ Res Public Health) - "Fifteen APIs were designated as safe (category (1):paracetamol, tramadol, amisulpride, citalopram, mirtazapine, metformin, gabapentin, lamotrigine, primidone, candesartan, irbesartan, atenolol, hydrochlorothiazide, ofloxacin, sulfadiazine), eleven as intermediately safe, and nine were of concern (azithromycin, ciprofloxacin, clarithromycin, sulfamethoxazole, carbamazepine, diclofenac, ibuprofen, iomeprol, iopromide). Where data do exist, we observed significant differences in environmental impact among the same class of drugs. Our classification could therefore help guide doctors to adopt more eco-friendly prescriptions."

Journal

Real-world Evidence of Efficacy, Use, and Discontinuation of Pharmacotherapies for the Treatment of Essential Tremor (P3-3.006). (PubMed, Neurology) - "The review targeted non-clinical trial studies of adults with ET evaluating propranolol, primidone, gabapentin, and/or topiramate, and reporting at least upper limb tremor efficacy, safety/adverse events, tolerability, and/or treatment patterns. Dr. LeWitt has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for CLINICAL NEUROPHARMACOLOGY."

HEOR • Journal • Real-world evidence • Review • Essential Tremor • Movement Disorders

Impact of cytochrome P-450 3A4 enzyme/P-glycoprotein inducing antiseizure medications on direct oral anticoagulant therapy. (PubMed, Blood Coagul Fibrinolysis) - "No excess risk of thrombosis during concomitant use of DOACs with CYP3A4/P-gp inducing antiseizure medications compared to use with gabapentin was identified. Further research is needed to confirm an association with excess all-cause mortality."

Journal • Atrial Fibrillation • Cardiovascular • CNS Disorders • Epilepsy • Hematological Disorders • Ischemic stroke • Venous Thromboembolism • CYP3A4

Phenotype Spectrum of TRPM3-Associated Disorders. (PubMed, Ann Neurol) - "Developmental delay/intellectual disability and epilepsy are dominant phenotypic features in patients with TRPM3 variants. Given that epilepsy can negatively impact development, screening for awake and sleep electroencephalogram abnormalities and other manifestations are essential to offer early intervention. The TRPM3 channel blocker primidone has shown promising effects and should be considered in every child with a TRPM3 gain-of-function variant. ANN NEUROL 2025;97:561-570."

Journal • Retrospective data • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • Musculoskeletal Diseases • TRPM3

Targeting TRPM3 as a potential therapeutic approach for autosomal dominant polycystic kidney disease. (PubMed, Sci Rep) - "We found that TRPM3 inhibitors (isosakuranetin, primidone, diclofenac) increased cyst formation, while TRPM3 activators (CIM0216 and nifedipine) greatly reduced cyst formation and reduced the sensitivity of kidneys to forskolin. These preclinical, in-vitro data suggest that TRPM3 may be a promising target in ADPKD management."

Journal • Autosomal Dominant Polycystic Kidney Disease • Genetic Disorders • Nephrology • Polycystic Kidney Disease • Renal Disease • PKD1 • PKD2 • PRKD1 • TRPM3

Convergent Agonist and Heat Activation of Nociceptor TRPM3. (PubMed, bioRxiv) - "Finally, we show that primidone binds to the same site as CIM0216 but acts as an antagonist. This study provides a framework for understanding the thermal sensing mechanisms of temperature-sensitive ion channels and offers a structural foundation for developing TRPM3-target therapeutics for pain and neurological disorders."

Journal • CNS Disorders • Epilepsy • Pain • TRPM3

The Pharmacological Management of Essential Tremor and Its Long-Term Effects on Patient Quality of Life: A Systematic Review. (PubMed, Cureus) - "Based on the studies, pharmacological treatments such as alprazolam, primidone, propranolol, and CX-8998 were found to be efficient in the management of ET...Novel approaches like low-intensity focused ultrasound (LIFU), transcutaneous afferent patterned stimulation (TAPS), and incobotulinumtoxinA injections presented promising results with improved tremor control and minimal side effects. In conclusion, pharmacological treatments for ET provide symptomatic relief but are limited by side effects and reduced long-term efficacy, significantly impacting QoL. Surgical and novel therapeutic options offer enhanced motor control and durability of effects, though they are not universally applicable."

HEOR • Journal • Review • CNS Disorders • Essential Tremor • Movement Disorders