The limitations of currently available therapies in addressing the non motor symptoms of Parkinson's disease (PD) have egged on the search for newer options. Zonisamide has been in use for epilepsy and it was serendipitously found to improve the symptoms of PD in a patient who had both epilepsy and PD. Thereafter, various trials were designed to assess the use of zonisamide in PD. The present article investigates the evidence for use of zonisamide in PD from the various clinical trials that were designed to address this issue. Furthermore, the article also summarizes the various mechanisms of its use in PD as described in various animal experiments. A search protocol was designed with predefined inclusion and exclusion criteria. The databases searched were Pubmed, Ovid medline, Cochrane and clinicaltrials.gov. The data thus generated, was fed into a predesigned format. Most of the clinical trials on zonisamide in PD have come from Japan. Most of these trials used the changes in the Unified Parkinson's Disease Rating Scale (UPDRS) score as the endpoints and the most conclusive evidence is for a dose of 25-50 mg, which caused a change in UPDRS part III (motor symptoms). These patients were on levodopa and other drugs used for PD during the trials. One of the clinical trials conducted in Spain investigates the use of zonisamide in impulse control disorders among 15 patients of PD. Among the many mechanisms postulated, a reduction in levodopa induced quinone formation, protection against mitochondrial impairment and an increase in astroglial cysteine transport, an inhibition of microglial activation, monoamine oxidase-B (MAO-B) inhibition, an increased dopamine release and blockade of calcium channels are the most cited. There is evidence for use of zonisamide in PD in addition to levodopa and other therapies for control of motor symptoms. For now, the evidence for its use in control of non motor symptoms in PD is not enough and needs to be investigated further.

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Background: Underreporting of various adverse drug reactions (ADRs) by consultants is a common incurable problem. National pharmacovigilance program is one of the ongoing programs to monitor the adverse drug reactions & reporting at the earliest to the nearby AMCs. As medical interns are budding doctors, the focus of this study was to evaluate the knowledge, attitude and perception about ADRs and pharmacovigilance in them.Methods: A cross section questionnaire-based study was conducted after approval by our institutional ethics committee pretested and validated questions consisting of 20 questions (knowledge, attitude, perception) were administrated to medical interns. The filled questionnaires were collected and analysed.Results: In our study, medical interns have fair enough idea about ADR and pharmacovigilance. In knowledge domain they were aware of term ADRs (100%), pharmacovigilance (72.6%). In attitude domain majority of interns (80.6%) known availability of ADR forms, compulsory of pharmacovigilance unit (90.3%). In perception domain very poor response from interns, not even a single intern had reported any ADR filled form and they don’t know meaning of re-challenge and de-challenge, very few interns (9.7%) know how to manage the ADRs in emergency conditions.Conclusions: Under reporting problem can be improved by doing more teaching activities at undergraduate level and intern’s level including various workshops, CMEs, problem-based teaching of adverse reactions in their curriculum. These exercises will improve their reporting frequency and sensitize the interns from the undergraduate days itself in their upcoming clinical practice in community.

Introduction: Many psychiatric disorders show signs and symptoms of anxiety and depression. A drug with both, effects and lesser adverse effects is always desired. Blonanserin is a novel drug with postulated effect on anxiety and depression. Aim:The study was aimed to evaluate the effect of Blonanserin on anxiety and depression in animal models. Materials and Methods:By using elevated plus maze test and forced swimming test, the antianxiety and antidepressant effects were evaluated. Animal ethics protocols were followed strictly. Total 50 rats (10 rats per group) were used for each test. As a control drug diazepam and imipramine were used in elevated plus maze and forced swimming test respectively. Blonanserin was tested for 3 doses 0.075, 0.2 and 0.8mg. These doses were selected from previous references as well as by extrapolating human doses.Results: This study showed an antianxiety effect of Blonanserin comparable to diazepam, which was statistically significant. Optimal effect was observed with 0.075mg, followed by 0.2 and 0.8mg. It also showed an antidepressant effect which was statistically significant. Optimal effect was observed at 0.2mg dose. Conclusion:The results showed that at a dose range of 0.075 and 0.2mg Blonanserin has potential to exert an adjuvant antianxiety and antidepressant activity in animal models. In order to extrapolate this in patient, longer clinical studies with comparable doses should be planned. The present study underlines potential of Blonanserin as a novel drug for such studies.