Could Adult European Pharmacoresistant Epilepsy Patients Be Treated With Higher Doses of Zonisamide?

Clinical Neuropharmacology
Júlia MiroMercè Falip

Abstract

To examine the clinical effect (efficacy and tolerability) of high doses of zonisamide (ZNS) (>500 mg/d) in adult patients with pharmacoresistant epilepsy. Between 2006 and 2013, all epileptic outpatients treated with high doses of ZNS were selected. Safety and efficacy were assessed based on patient and caregiver reports. Serum levels of ZNS and other concomitant antiepileptic drugs were evaluated if available. Nine patients (5 female): 8 focal/1 generalized pharmacoresistant epilepsy. Mean age: 34 years. Most frequent seizure type: complex partial seizures; other seizure types: generalized tonic-clonic, tonic, myoclonia. Zonisamide in polytherapy in all (100%), administered in tritherapy in 3 (33%) of 9 patients; mean dose: 633 (600-700) mg/d; efficacy (>50% seizure reduction) was observed in 5 (55%) of 9 patients. Five of 9 patients are still taking high doses of ZNS (more than 1 year). Adverse events were observed in 3 (37%) of 8 patients. Good tolerance to high doses of other antiepileptic drugs had been observed in 6 (66%) of 9 patients. Plasma levels of ZNS were only available in 2 patients; both were in the therapeutic range (34.95, 30.91) (10-40 mg/L). High doses of ZNS are effective and safe in pharmacoresistant epile...Continue Reading

References

Dec 20, 2005·Epilepsia·Martin J Brodie
Oct 20, 2006·Clinical Pharmacokinetics·Svein I Johannessen, Torbjörn Tomson
Feb 27, 2007·Epilepsia·Graeme Sills, Martin Brodie
Apr 25, 2008·Expert Opinion on Drug Metabolism & Toxicology·Sanjeev V Kothare, Joseph Kaleyias
Dec 25, 2008·The New England Journal of Medicine·Jessica L MegaMarc S Sabatine
Dec 17, 2009·Expert Opinion on Pharmacotherapy·Andreas Schulze-Bonhage
Mar 15, 2013·Clinical Pharmacology and Therapeutics·J K HicksUNKNOWN Clinical Pharmacogenetics Implementation Consortium
Jun 8, 2014·Epilepsy Research·Reana VelizarovaPhilippe Gelisse

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Citations

Sep 26, 2017·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Mindl M MessingerShannon M DiCarlo

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