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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]
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The enzymes CYP2E1, CYP2A6, CYP2B6, CYP2C19 and CYP3A4 play smaller roles in the drug's metabolism. [14] Steady state conditions are reached after 14 days. Cenobamate and its metabolites are mostly eliminated via the urine and only to 5.2% via the faeces. The terminal half-life is 50 to 60 hours. [14]
Phenobarbital was first used in 1912 for both its sedative and antiepileptic properties. By the 1930s, the development of animal models in epilepsy research led to the development of phenytoin by Tracy Putnam and H. Houston Merritt , which had the distinct advantage of treating epileptic seizures with less sedation. [ 44 ]