Zonisamide

Abstract

Summary: Zonisamide (ZNS) is a broad-spectrum antiepileptic drug in both animal models of epilepsy and patients with epilepsy. It is effective for both localization-related and generalized epilepsies and appears to be particularly potent in progressive myoclonic epilepsy syndromes. Its pharmokinetic profile is favorable, with a long half-life and low protein binding.However, its insolubility may make the development of a parenteral formulation difficult. Its safety profile is good, although teratogenicity in animal models is of concern. Adult doses of 400-600 mg per day in two doses, with blood levels from 20 to 30 mg/ml, appear to be effective.

Cortical hyperexcitability and epileptogenesis: Understanding the mechanisms of epilepsy – Part 1

“…55 They include: carbamazepine; 56 phenytoin, which also reduces Ca 2+ currents; 57 oxcarbazepine; 58,59 lamotrigine, which also reduces glutamate release and blocks Ca 2+ channels; 60,61 and zonisamide, which also blocks T-type Ca 2+ channels and enhances GABA action. [62][63][64] Voltage gated calcium channelopathies. Variants in the CAC-NA1H coding for the voltage gated T-type Ca 2+ channel are present in patients with various generalised epilepsy syndromes 65 and this might be an important susceptibility gene involved in the pathogenesis of childhood absence epilepsy (CAE).…”

A New Look at the Second-Generation Antiepileptic Drugs

“…18 Topiramate has low protein binding and is predominantly renally eliminated but does induce the metabolism of oral contraceptive pills (OCPs) when taken at doses above 200 mg/d. 19 Oxcarbazepine is rapidly reduced to its active metabolite, a monohydroxy derivative (MHD) that undergoes predominantly hepatic metabolism via glucouronidation. Oxcarbazepine has been shown to increase metabolism of OCPs but does not interact with erythromycin, cimetidine, or warfarin, as seen with carbamazepine.…”

Advances in our understanding of early childhood epilepsies: 1999–2000

“…Experience with zonisamide in countries where it has been available for a longer time indicates that it has a broad spectrum of anticonvulsant activity in children. In addition to partial seizures, it can be effective for generalized tonic-clonic seizures, myoclonic epilepsy, and refractory absence seizures [22,23]. It is also effective in some cases of Lennox-Gastaut syndrome and infantile spasms [24,25].…”