Zonisamide in the treatment of epilepsy

Schulze‐Bonhage, Andreas

doi:10.1517/14656560903468728

Cited by 31 publications

(19 citation statements)

References 90 publications

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“…It is used as an adjunctive therapy in the treatment of partial seizures (with or without generalization) in adults [1]. Following oral administration, ZNM is almost completely absorbed from the gastrointestinal tract, irrespective of food intake reaching maximal plasma concentrations within 2–5 h under fasting conditions and 4–6 h with food [2, 3]. It is predominantly metabolized in the liver with subsequent elimination by the kidney.…”

Section: Introductionmentioning

confidence: 99%

Impact of Pregnancy on Zonisamide Pharmacokinetics in Rabbits

Matar

2013

BioMed Research International

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Pregnancy is associated with various physiological changes which may lead to significant alterations in the pharmacokinetics of many drugs. The present study was aimed to investigate the potential effects of pregnancy on the pharmacokinetic profile of zonisamide (ZNM) in the rabbit. Seven female rabbits were used in this study. The pregnant and nonpregnant rabbits received ZNM orally at a dose of 10 mg/kg and blood samples were collected from the animals just before receiving the drug and then serially for up to 24 h. The plasma samples were analyzed using tandem mass spectrometric method. Following a single oral dose of ZNM to the rabbits, the mean values of ZNM plasma concentrations at different times were consistently low in pregnant compared to nonpregnant rabbits. The mean values of ZNM's C max and AUC0−∞ were significantly (P < 0.05) decreased, whereas the CL/F exhibited substantial increase (P < 0.05) in pregnant compared to nonpregnant rabbits. T max, t 1/2abs, t 1/2el, MRT, and Vd/F showed no significant differences between the two groups. The present study demonstrates that pregnancy decreased ZNM plasma concentrations in rabbits and that the decrease could be due to decreased extent of gastrointestinal absorption, induced hepatic metabolism, or enhanced renal elimination of the drug.

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Section: Introductionmentioning

confidence: 99%

Impact of Pregnancy on Zonisamide Pharmacokinetics in Rabbits

Matar

2013

BioMed Research International

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“…ZNS has been recommended as a Class I AED for initial monotherapy based on a comparative study with carbamazepine (CBZ) showing no statistically significant differences in efficacy and tolerability [1,2]. Structurally, it is unrelated to other available antiepileptic drugs, and consists of a benzisoxazole ring structure with a [3]. Despite worldwide exposure of high patient numbers for long treatment periods, the most relevant studies assessing long-term efficacy and tolerability of ZNS were published only in 2014, adding important information to an earlier review on this topic [4].…”

Section: Specific Characteristics Of Znsmentioning

confidence: 99%

The safety and long-term efficacy of zonisamide as adjunctive therapy for focal epilepsy

Schulze‐Bonhage

2015

Expert Review of Neurotherapeutics

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Epilepsy is a chronic disease which affects 1% of the population worldwide. As treatment is required for many years or decades, the long-term efficacy and tolerability of antiepileptic drugs are particularly important. Zonisamide (ZNS) is a second-generation antiepileptic drug with a unique structure and multiple mechanisms of action. Here, recently published long-term outcomes of patient cohorts with focal epilepsy undergoing ZNS treatment are discussed. Whereas ZNS monotherapy maintains similar seizure control efficacy to carbamazepine after 2 years of treatment, seizure-free rates are low in pharmacoresistant patients undergoing late adjunctive therapy. In preselected patient populations derived from double-blind studies, long-term seizure reduction and responder rates support sustained ZNS efficacy, good adherence and long-term retention. Adverse effects include somnolence and weight decrease, but data suggest that long-term treatment with ZNS is safe with only rare newly occurring adverse effects, and good long-term tolerability also regarding mood, behavior, cognition and bone maturation.

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“…Эффектив-ность и безопасность зонисамида в лечении фокаль-ных и генерализованных приступов доказаны в кли-нических исследованиях II и III фазы [83]. Зонисамид также может быть эффективен при идиопатической генерализованной эпилепсии (ИГЭ) и некоторых фор-мах эпилепсии, трудно поддающихся терапии, вклю-чая синдромы Веста, Леннокса-Гасто, Драве и Дозе [39,42,43,82,93,112]. Зонисамид может быть эффек-тивен при типичных и атипичных абсансах, тониче-ских и миоклонических приступах [5,112] [15,16].…”

Section: эффективность зонисамида в лечении эпилепсииunclassified