Handley and Stewart demonstrated its effectiveness in the treatment of patients who failed to respond to other therapies; it was noted to be more effective in people with idiopathic generalized epilepsy than in people whose epilepsy had a known cause. Dr. Whitty noted in 1953 that it benefitted patients with psychomotor epilepsy, who were often treatment-resistant. Toxic effects were reported to be mild. That same year, it was approved in France. Primidone was introduced in 1954 under the brandname Mysoline by Wyeth in the United States. Association with megaloblastic anemia
In 1954, Chalmers and Boheimer reported that the drug was associated with megaloblastic anemia. Between 1954 and 1957, twenty-one cases of megaloblastic anemia associated with primidone and/or phenytoin were reported. In most of these cases the anemia was due to vitamin deficiencies: usually folic acid deficiency; in one case Vitamin B12 deficiency and in one case Vitamin C deficiency. Some cases were associated with deficient diets: one patient ate mostly bread and butter, another ate bread, buns, and hard candy, and another could rarely be persuaded to eat in the hospital.The idea that folic acid deficiency could cause megaloblastic anemia was not new. What was new was the idea that drugs could cause this in well-nourished people with no intestinal abnormalities. In many cases, it was not clear which drug had caused it. It was speculated that this might be related to the structural similarity between folic acid, phenytoin, phenobarbital, and primidone.
Primidone, sold under various brand names, is a barbiturate medication that is used to treat partial and generalized seizures, as well as essential tremors. It is taken by mouth.Common side effects include sleepiness, poor coordination, nausea, and loss of appetite. Severe side effects may include suicide, psychosis, a lack of blood cells. Use during pregnancy may result in harm to the baby. Primidone is an anticonvulsant of the barbiturate class. How it works is not entirely clear.Primidone was approved for medical use in the United States in 1954. It is available as a generic medication. In 2017, it was the 238th most commonly prescribed medication in the United States, with more than two million prescriptions. Medical uses
Epilepsy
Licensed for generalized tonic-clonic and complex partial seizures in the United Kingdom. In the United States, primidone is approved for adjunctive (in combination with other drugs) and monotherapy (by itself) use in generalized tonic-clonic seizures, simple partial seizures, and complex partial seizures, and myoclonic seizures. In juvenile myoclonic epilepsy (JME), it is a second-line therapy, reserved for when the valproates or lamotrigine do not work and when other second-line therapies—acetazolamide work either.Open-label case series have suggested that primidone is effective in the treatment of epilepsy. Primidone has been compared to phenytoin, phenobarbital, mephobarbital, ethotoin, metharbital, and mephenytoin. In adult comparison trials, primidone has been found to be just as effective. Essential tremor
Primidone is considered to be a first-line therapy for essential tremor along with propranolol.