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Primidone is an oral anticonvulsant medication primarily used to control various types of seizures, including grand mal (generalized tonic-clonic), psychomotor, and focal epileptic seizures. It is also indicated for the management of essential tremor. Primidone belongs to the barbiturate anticonvulsant class and works by decreasing abnormal electrical activity in the brain. Its mechanism involves altering sodium and calcium channel transport, thereby reducing nerve firing frequency. Primidone itself has anticonvulsant activity, as do its active metabolites phenobarbital and phenylethylmalonamide (PEMA). While primidone does not directly interact with GABA-A receptors or chloride channels, its metabolite phenobarbital does[1][2][6][8]. The drug was first approved for use in epilepsy in 1954[8].
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