Zonisamide discontinuation due to psychiatric and cognitive adverse events

White, James R.; Walczak, Thaddeus S.; Marino, Susan E.; Beniak, Thomas E.; Leppik, Ilo E.; Birnbaum, Angela K.

doi:10.1212/wnl.0b013e3181eccfb5

Cited by 55 publications

(39 citation statements)

References 23 publications

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“…Although CAEs are often the most common reason for discontinuation of zonisamide, perhaps only 5.8% will withdraw from treatment for this reason [White et al 2010]. There are conflicting findings as to the prevalence of CAEs.…”

Section: Zonisamidementioning

confidence: 99%

The cognitive impact of antiepileptic drugs

Eddy¹,

Rickards²,

Cavanna³

2011

Ther Adv Neurol Disord

324

189

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Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs.

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Section: Zonisamidementioning

confidence: 99%

The cognitive impact of antiepileptic drugs

Eddy¹,

Rickards²,

Cavanna³

2011

Ther Adv Neurol Disord

324

189

View full text Add to dashboard Cite

show abstract

“…Patients with a history of psychiatric condition were twice as likely to have IACEs to two or more AEDs compared to patients without a history of psychiatric condition. A past psychiatric history has been shown to be an independent predictor of ACEs in previous studies [16,17]. As postulated in a prior study by Kanner et al, concomitant anxiety and depression might increase the "complaint rate" (i.e., the tendency to report side effects) [16].…”

Section: Discussionmentioning

confidence: 81%

“…Additionally, there was no specific crosssensitivity between TPM and ZNS in our study. Two prior studies also reported relatively low rates of adverse cognitive and psychiatric effects of ZNS [17,27]. The better tolerability profile of ZNS than TPM suggests that properties other than their shared chemical structure are likely causative of cognitive effects.…”

Section: Discussionmentioning

confidence: 90%

Cross-sensitivity of patient-perceived adverse cognitive effects with antiepileptic drug use

Chen

Detyniecki

Hirsch

et al. 2015

Epilepsy & Behavior

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“…39 Impaired cognitive function is the most common reason of discontinuation. 40 Dose related decline in attention, memory and verbal fluency has been noted. 41 Usual adult daily dose of zonisamide is 200-600 mg and target range of plasma concentration is 10-40 µg/ml.…”

Section: Zonisamidementioning

confidence: 99%