Primidone for Anxiety: What You Need to Know About This Seizure Drug and Its Off-Label Use

When people talk about primidone, a barbiturate-derived anticonvulsant originally developed to control seizures. Also known as Mysoline, it's been around since the 1950s and is still prescribed today for epilepsy, especially when other drugs fail. But here’s something you might not expect: some doctors and patients use it for anxiety—not as a first choice, but when everything else hasn’t worked.

Primidone doesn’t work like Xanax or SSRIs. It slows down overactive brain signals, which is why it stops seizures. That same calming effect can help reduce the jittery, racing thoughts that come with severe anxiety. It’s not FDA-approved for anxiety, but there’s real-world evidence—mostly from small studies and long-term patient reports—that it helps people with treatment-resistant anxiety, especially when paired with other meds. It’s not for everyone. Side effects like dizziness, fatigue, and brain fog can be heavy, and because it’s metabolized into phenobarbital, there’s a risk of dependence if used long-term.

People who’ve tried SSRIs, benzodiazepines, or beta-blockers and still struggle with panic attacks or chronic worry sometimes turn to primidone as a last resort. It’s not quick-acting. It takes weeks to build up in your system. But for some, it brings a steady calm that other drugs can’t match. If you’re considering it, talk to a neurologist or psychiatrist who’s familiar with off-label use. They’ll check your liver function, monitor blood levels, and make sure it doesn’t clash with other meds you’re taking—especially if you’re on something like levetiracetam, a common seizure drug often compared to primidone or trazodone, a sleep and mood aid sometimes used for anxiety.

The posts below dive into real comparisons and patient experiences with primidone and similar drugs. You’ll find how it stacks up against other seizure treatments, what side effects to watch for, and why some people swear by it for anxiety while others can’t tolerate it. No fluff. Just straight facts from people who’ve been there.