Zonisamide for essential tremor: an evaluator-blinded study.
In this evaluator-blinded open-treatment trial, subjects with moderate/severe upper limb essential tremor were titrated to 300 mg/day zonisamide, or adjusted to a lesser dose if symptoms warranted, as monotherapy or as adjunct to stable antitremor medication, followed by a 12-week extension phase. The primary efficacy outcome variables were blinded rater videotaped/drawing tremor score changes at the Treatment and Extension visits compared to Baseline, based on Fahn-Tolosa-Marin and Postural Tremor Scales. Subjects also rated Functional Disabilities. Primary outcomes showed reduced tremor scores at the Treatment (P < 0.00001, n = 25) and Extension (n = 16) visits, at mean doses of 252 and 225 mg/day, respectively. Subject ratings indicated 200 mg/day was superior to 100 mg/day, whereas 300 mg/day produced no additional benefit, but instead was associated with more adverse symptoms, most commonly somnolence, poor energy, imbalance, and altered taste. Future double-blind placebo-controlled trials are warranted.
Handforth
Adrian
A
Department of Neurology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA. charles.handforth@med.va.gov
Martin
Fredricka C
FC
Kang
Gail A
GA
Vanek
Zeba
Z
D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D020329:Essential Tremor / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D008297:Male; D012720:Severity of Illness Index; D016037:Single-Blind Method; D034941:Upper Extremity / Q000503:physiopathology; D000078305:Zonisamide
D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide