Side Effects of zonisamide: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major Research Findings

Zonisamide is widely used as an anti-epileptic drug, but various side effects have been reported. 21 shows that zonisamide can cause weight loss. 22 suggests that zonisamide may have been associated with intolerance in patients with depression. 3 reports that zonisamide may be used to treat infantile spasms, but side effects such as weight loss, drowsiness, and gastrointestinal symptoms have been reported. 10 also reports that zonisamide may affect cognitive function and fatigue. 14 suggests that zonisamide may increase the risk of psychiatric and behavioral side effects when used in combination with other anti-epileptic drugs. 8 reports that zonisamide may cause drug rash with eosinophilia and systemic symptoms (DRESS) as a serious side effect. 28 suggests that zonisamide may cause psychiatric side effects, and this risk may be increased in patients with a pre-existing psychiatric history. 1 reports that zonisamide may cause drug-induced liver injury, especially in the elderly.

Reasons for side effects

The reason why zonisamide causes various side effects is because its mechanism of action is not yet fully understood. 11 points out that the mechanism of action of zonisamide is not yet fully understood. 13 suggests that the fact that zonisamide acts as a carbonic anhydrase inhibitor is one of the causes of its side effects. 5 shows that zonisamide has the effect of improving obstructive sleep apnea due to its carbonic anhydrase inhibitory effect, but it also suggests that it may cause side effects. 9 suggests that zonisamide may affect AMPA receptors. AMPA receptors are important receptors involved in neurotransmission in the brain, and zonisamide may cause various side effects by affecting AMPA receptors.

Common side effects

Weight Loss

Zonisamide may cause weight loss. 21 shows that zonisamide may cause weight loss. 3 reports that weight loss was observed as a side effect when zonisamide was used to treat infantile spasms.

Drowsiness

Zonisamide may cause drowsiness. 3 reports that drowsiness was observed as a side effect when zonisamide was used to treat infantile spasms.

Gastrointestinal symptoms

Zonisamide may cause gastrointestinal symptoms. 3 reports that gastrointestinal symptoms were observed as a side effect when zonisamide was used to treat infantile spasms.

Psychiatric and behavioral side effects

Zonisamide may cause psychiatric and behavioral side effects. 22 suggests that zonisamide may have been associated with intolerance in patients with depression. 14 suggests that zonisamide may increase the risk of psychiatric and behavioral side effects when used in combination with other anti-epileptic drugs. 28 suggests that zonisamide may cause psychiatric side effects, and this risk may be increased in patients with a pre-existing psychiatric history.

Effects on cognitive function

Zonisamide may affect cognitive function. 10 also reports that zonisamide may affect cognitive function and fatigue.

Drug rash with eosinophilia and systemic symptoms (DRESS)

Zonisamide may cause drug rash with eosinophilia and systemic symptoms (DRESS) as a serious side effect. 8 reports that zonisamide may cause drug rash with eosinophilia and systemic symptoms (DRESS) as a serious side effect.

Drug-induced liver injury

Zonisamide may cause drug-induced liver injury, especially in the elderly. 1 reports that zonisamide may cause drug-induced liver injury, especially in the elderly.

Side effects countermeasures

Weight Loss

If you are concerned about weight loss, consult your doctor to discuss appropriate measures such as dietary therapy and exercise therapy. 21 shows that zonisamide may cause weight loss, but does not mention specific countermeasures.

Drowsiness

If you feel drowsy, avoid activities that require concentration, such as driving or operating machinery. 3 reports that drowsiness was observed as a side effect when zonisamide was used to treat infantile spasms, but does not mention specific countermeasures.

Gastrointestinal symptoms

If you are concerned about gastrointestinal symptoms, consult your doctor to discuss appropriate measures such as medication. 3 reports that gastrointestinal symptoms were observed as a side effect when zonisamide was used to treat infantile spasms, but does not mention specific countermeasures.

Psychiatric and behavioral side effects

If you experience psychiatric and behavioral side effects, consult your doctor to discuss appropriate measures such as medication. 22 suggests that zonisamide may have been associated with intolerance in patients with depression, but does not mention specific countermeasures. 14 suggests that zonisamide may increase the risk of psychiatric and behavioral side effects when used in combination with other anti-epileptic drugs, but does not mention specific countermeasures. 28 suggests that zonisamide may cause psychiatric side effects, and this risk may be increased in patients with a pre-existing psychiatric history, but does not mention specific countermeasures.

Effects on cognitive function

If you are concerned about the effects on cognitive function, consult your doctor to discuss appropriate measures. 10 also reports that zonisamide may affect cognitive function and fatigue, but does not mention specific countermeasures.

Drug rash with eosinophilia and systemic symptoms (DRESS)

If you experience symptoms of drug rash with eosinophilia and systemic symptoms (DRESS), seek immediate medical attention. 8 reports that zonisamide may cause drug rash with eosinophilia and systemic symptoms (DRESS) as a serious side effect, but does not mention specific countermeasures.

Drug-induced liver injury

If you are concerned about drug-induced liver injury, follow your doctor's instructions, such as getting regular blood tests. 1 reports that zonisamide may cause drug-induced liver injury, especially in the elderly, but does not mention specific countermeasures.

Comparison between studies

Commonalities among studies

Multiple studies have reported that zonisamide may cause various side effects.

Differences between studies

The frequency, severity, and types of side effects of zonisamide vary across studies.

Precautions for application in real life

When taking zonisamide, it is important to understand the risks of side effects and take the medication as directed by your doctor.

Limitations of current research

Research on the mechanism of action and side effects of zonisamide is not yet sufficient.

Future research directions

Further research is needed to better understand the mechanism of action and side effects of zonisamide.

Conclusion

Zonisamide is an effective anti-epileptic drug, but it may cause various side effects. When taking zonisamide, it is important to understand the risks of side effects and take the medication as directed by your doctor.

Literature analysis of 28 papers
Positive Content
21
Neutral Content
3
Negative Content
4
Article Type
1
1
1
12
27
1.

Drug-induced liver injury associated with the use of newer antiseizure medications in the elderly: an analysis of data from VigiBase.

Author: PetrovićSanja, KovačevićMilena, Vezmar KovačevićSandra, MiljkovicBranislava

DILI prevention
DILI
Newer ASMs

This study analyzed Individual Case Safety Reports (ICSRs) of drug-induced liver injury (DILI) in elderly patients treated with newer antiseizure medications (ASMs) reported to VigiBase. Signals were detected for lamotrigine, levetiracetam, oxcarbazepine, topiramate, and zonisamide. Age- and gender-biased reporting frequency was identified for topiramate-induced hyperammonemia, with higher frequency in ≥75-year-old male patients.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Role of high-dose levetiracetam as add-on therapy for intractable epilepsy: case report and brief review of the literature.

Author: Mateo-CarrascoHector, Serrano-CastroPedro Jesús, Molina-CuadradoEmilio, GoodwinMel, NguyenTimothy V, KotechaPrimal N

Seizure frequency reduction
Agitation
Depression

This case report describes a 5-year-old long-standing epileptic woman who received oxcarbazepine, levetiracetam, and zonisamide.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Recent advances in the pharmacotherapy of infantile spasms.

Author: RiikonenRaili

Improved cognitive outcome
Infantile spasms treatment
Side effects

This review examines recent developments in the pharmacotherapy of infantile spasms, focusing on first-line treatments such as ACTH, oral corticosteroids, and vigabatrin, as well as other antiepileptic drugs and novel treatments. The article highlights the importance of early intervention and the potential for preventive treatments.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Retention rate of zonisamide in intractable epilepsy.

Author: NakkenK O, LindstrømP, AndersenH

Improved QOL
Reduced seizure frequency
CNS side effects
Withdrawal

Zonisamide has a retention rate of 53.6% after 1 year of treatment which is roughly in accordance with the retention rates found for other drugs in drug-resistant patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Zonisamide reduces obstructive sleep apnoea: a randomised placebo-controlled study.

Author: EskandariDavoud, ZouDing, KarimiMahssa, StenlöfKaj, GroteLudger, HednerJan

OSA reduction
Weight loss
Side effects

Zonisamide, a carbonic anhydrase inhibitor, reduces apnoeic events in sleep disordered breathing and induces weight loss in obese patients. In a 4-week study, zonisamide reduced apnoea/hypopnoea index by 33% and oxygen desaturation index by 28% compared to placebo. However, the effect was less pronounced than continuous positive airway pressure (CPAP). After 24 weeks, zonisamide reduced AHI by 13% and CPAP by 61%.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Update on once-daily zonisamide monotherapy in partial seizures.

Author: AfraPegah, AdamolekunBola

Monotherapy option
Long-term side effects

Zonisamide is an antiepileptic medication that is different from other antiepileptic drugs. It is approved for use in epilepsy treatment in many countries, including Japan, South Korea, and Europe. However, in the USA, it is only approved for use alongside other medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Bupropion/zonisamide combination to assist smokers to switch from combustible cigarettes to electronic nicotine delivery systems (ENDS).

Author: RoseJed E, WillettePerry N, BottsTanaia L, BottsDavid R, BehmFrederique M

ENDS switching

This study investigated the potential of combining bupropion and zonisamide, two FDA-approved medications, to help smokers switch from combustible cigarettes to electronic nicotine delivery systems (ENDS). Both medications have been shown to reduce cravings for cigarettes and may offset each other's side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome in a paediatric patient taking zonisamide.

Author: TrivediAshifa, SharmaSadhna, GovindanRanjith

DRESS syndrome

This case report describes an 11-year-old male patient who developed drug rash with eosinophilia and systemic symptoms (DRESS syndrome) after starting zonisamide. The patient was successfully treated with pulsed intravenous methylprednisolone and intravenous immunoglobulin.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Cognitive and fatigue side effects of anti-epileptic drugs: an analysis of phase III add-on trials.

Author: SarkisRani A, GoksenYazel, MuYi, RosnerBernard, LeeJong Woo

Cognitive side effects
Fatigue

This study analyzes the terms used to refer to cognitive and fatigue-related side effects in phase III add-on clinical trials of anti-epileptic drugs (AEDs). The findings indicate a significant dose-response effect for most AEDs, suggesting that physicians should consider aiming for lower drug loads to improve tolerability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Tolerability of lacosamide or zonisamide in elderly patients with seizures.

Author: SarkisRani A, NicolasJohny, LeeJong Woo

Lacosamide and zonisamide are viable options for the treatment of epilepsy in the elderly.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Treatment of status epilepticus with zonisamide: A multicenter cohort study of 34 patients and review of literature.

Author: HubertKristina, KnakeSusanne, BauerSebastian, VossMartin, RosenowFelix, StrzelczykAdam

Status epilepticus treatment
Ataxia
Skin rash

A retrospective review of 37 status epilepticus (SE) episodes in 34 patients found that oral zonisamide was effective in resolving 16.2% of episodes, particularly those that were refractory or super-refractory to other treatments. Zonisamide was administered after a median latency of 6.3 days and after patients had already undergone unsuccessful treatment with a median of three other antiseizure drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Drug interaction considerations in the therapeutic use of carbonic anhydrase inhibitors.

Author: SupuranClaudiu T

Anti-high altitude disease
Antiepileptic
Antiglaucoma
Antiobesity
Diuretic

Carbonic anhydrase inhibitors are clinically used for various conditions, including glaucoma, epilepsy, and high altitude sickness. They are also being investigated as anticancer agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use.

Author: ChenBaibing, ChoiHyunmi, HirschLawrence J, LeggeAlexander, BuchsbaumRichard, DetynieckiKamil

Behavioral side effects
Psychiatric side effects

Patients with a history of depression or psychosis have an increased risk of experiencing intolerable psychiatric and behavioral side effects from antiepileptic drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Treatment of essential tremor: a systematic review of evidence and recommendations from the Italian Movement Disorders Association.

Author: ZappiaMario, AlbaneseAlberto, BrunoElisa, ColosimoCarlo, FilippiniGraziella, MartinelliPaolo, NicolettiAlessandra, QuattrocchiGraziella, AbbruzzeseGiovanni, BerardelliAlfredo, AllegraRoberta, AnielloMaria Stella, EliaAntonio E, MartinoDavide, MurgiaDaniela, PicilloMarina, SquintaniGiovanna

First-line therapy
Refractory ET treatment
Second-line treatment
Side effects

This review assesses the current state of knowledge regarding essential tremor (ET) therapy. Propranolol, primidone, and topiramate are recommended as first-line treatment options, while botulinum toxin type A and thalamic deep-brain stimulation are reserved for refractory ET.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

[Epilepsy in the elderly].

Author: NakkenKarl O, SætreErik, MarkhusRune, LossiusMorten I

Epilepsy management

Epilepsy in elderly patients is a challenging condition to diagnose and treat.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Norwegian

17.

Cannabis for the Treatment of Epilepsy: an Update.

Author: GastonTyler E, SzaflarskiJerzy P

Epilepsy treatment

Cannabidiol (CBD), a non-psychoactive component of cannabis, has shown potential for treating epilepsy. Recent controlled studies have provided more evidence for its efficacy in treating various forms of epilepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Cognitive and behavioral effects of new antiepileptic drugs in pediatric epilepsy.

Author: MoaveroRomina, SantaroneMarta Elena, GalassoCinzia, CuratoloPaolo

Improved behavior
Improved cognition

This paper discusses the impact of new and newest antiepileptic drugs on cognition and behavior in children with epilepsy. It aims to guide clinicians in choosing the most appropriate medication for epilepsy associated with specific neurodevelopmental disorders.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Non-Dopaminergic Treatments for Motor Control in Parkinson's Disease: An Update.

Author: Gonzalez-LatapiPaulina, BhowmickSuvorit Subhas, SaranzaGerard, FoxSusan H

Improved motor symptoms
Side effects of dopamine replacement therapy

This review discusses advancements in non-dopaminergic treatments for Parkinson's disease. While no non-dopaminergic drug has shown long-term efficacy as monotherapy, several are being investigated for treating motor complications of dopamine replacement therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Weight-reducing side effects of the antiepileptic agents topiramate and zonisamide.

Author: AntelJ, HebebrandJ

Weight loss

Topiramate and zonisamide, two antiepileptic drugs, can cause significant weight loss. This review discusses potential molecular mechanisms responsible for this effect and examines clinical studies on these drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

Zonisamide monotherapy for idiopathic epilepsy in dogs.

Author: ChungJ Y, HwangC Y, ChaeJ S, AhnJ O, KimT H, SeoK W, LeeS Y, YounH Y

Reduced seizure frequency
Mild side effects

Zonisamide monotherapy was effective in treating some dogs with idiopathic epilepsy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

Effect of Anti-seizure Medications on Functional Anatomy of Language: A Perspective From Language Functional Magnetic Resonance Imaging.

Author: XiaoFenglai, CaciagliLorenzo, WandschneiderBritta, JoshiBhavini, VosSjoerd B, HillAndrea, GalovicMarian, LongLili, SoneDaichi, TrimmelKarin, SanderJosemir W, ZhouDong, ThompsonPamela J, BaxendaleSallie, DuncanJohn S, KoeppMatthias J

Cognitive function

This study aims to elucidate the cognitive effects of anti-seizure medications, highlighting the need for further research to determine the impact of different dosages and combinations of these medications on cognitive function in epilepsy patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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