.Hi, my first post here, sorry about the bad english.^_^
.This is actually a psychiatric issue but I believe if I post it in here I‘ll get better answers anyways.
.How should I switch a non-epileptic patient who is tapering diazepam to primidone? My concern is primidone's cyp450 isozyme inducing properties. I'm not sure when to start primidone before withdrawing the benzo to give primidone some time to work properly. The patient is 51kg/180m, 30 years old white male, currently on 8.5 mg diazepam (tapering 1.25 mg every two weeks – originally tapered from 13-14 mg flunitrazepam to 5 mg and then switched to diazepam) and have no health problems currently (he had an ischemic stroke (at left occipital lobe) – no known cause, probably due to substance abuse - in 2002 and not treated and has %30-%40 vision loss other than this patient is OK). I've rechecked and 7 cyp450 substrates of diazepam is interacting with primidone/phenobarb so is there any chance of primidone increase diazepam metabolism and reduce diazepam levels in body via enzyme induction?.
.thanks for your time.
.This is actually a psychiatric issue but I believe if I post it in here I‘ll get better answers anyways.
.How should I switch a non-epileptic patient who is tapering diazepam to primidone? My concern is primidone's cyp450 isozyme inducing properties. I'm not sure when to start primidone before withdrawing the benzo to give primidone some time to work properly. The patient is 51kg/180m, 30 years old white male, currently on 8.5 mg diazepam (tapering 1.25 mg every two weeks – originally tapered from 13-14 mg flunitrazepam to 5 mg and then switched to diazepam) and have no health problems currently (he had an ischemic stroke (at left occipital lobe) – no known cause, probably due to substance abuse - in 2002 and not treated and has %30-%40 vision loss other than this patient is OK). I've rechecked and 7 cyp450 substrates of diazepam is interacting with primidone/phenobarb so is there any chance of primidone increase diazepam metabolism and reduce diazepam levels in body via enzyme induction?.
.thanks for your time.
