Abstract
Phenobarbital and primidone have long treatment traditions. Many of the clinical studies have been performed in limited groups of patients, and few randomized controlled trials comparing other relevant AEDs have been published. Side effects include CNS-related effects as sedation, and development of tolerance over time. Phenobarbital and primidone have linear pharmacokinetics, but have enzyme-inducing properties, affecting concomitant medication. Therapeutic drug monitoring is a tool to optimize the therapy with both phenobarbital and primidone in the individual patient. Phenobarbital has still a place in the treatment of various seizure forms, whereas the use of primidone, as a metabolite of phenobarbital, has a more limited place in modern treatment of epilepsy. Phenobarbital is one of the most available drugs in the world based upon the WHO list of essential medicines (WHO), due to its efficacy, low cost, and a possibility to balance efficacy and tolerability, especially in resource-limited areas.
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Johannessen, S.I., Johannessen Landmark, C. (2020). Anti-Convulsant Agents: Phenobarbital and Primidone. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_302-1
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