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Primidone is an anticonvulsant of the barbiturate class; [7] however, its long-term effect in raising the seizure threshold is likely due to its active metabolite, phenobarbital. [10] The drug’s other active metabolite is phenylethylmalonamide (PEMA). Primidone was approved for medical use in the United States in 1954. [7]
Many prescription and legal nonprescription substances can also cause withdrawal symptoms when individuals stop consuming them, even if they were taken as directed by a physician. The route of administration, whether intravenous , intramuscular , oral , or otherwise can also play a role in determining the severity of withdrawal symptoms.
Methods of prevention include gradually decreasing the dose among those who wish to stop, though it is possible for symptoms to occur with tapering. [2] [6] [4] Treatment may include restarting the medication and slowly decreasing the dose. [2] People may also be switched to the long-acting antidepressant fluoxetine which can then be gradually ...
Generally, a comedown can happen to anyone as a transient symptom, but in people who are dependent on the drug (especially those addicted to it), it is an early symptom of withdrawal and thus can be followed by others. Various drug classes, most especially stimulants and, to a lesser degree, opioids and sedatives, are subject to comedowns. [2]
The rebound effect, or pharmaceutical rebound phenomenon, is the emergence or re-emergence of symptoms that were either absent or controlled while taking a medication, but appear when that same medication is discontinued, or reduced in dosage.
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The vagus nerve stimulator is a device that can be implanted into patients with epilepsy, especially that which originates from a specific part of the brain. However, both of these treatment options can cause severe adverse effects. Additionally, while seizure frequency typically decreases, they often do not stop entirely. [40] [41]
Treatment can be problematic: Barbiturates and primidone must be avoided as they commonly precipitate symptoms. [28] Some benzodiazepines are safe, and, when used in conjunction with newer anti-seizure medications such as gabapentin , offer a possible regimen for seizure control.