[Role of zonisamid in treating epilepsy, Parkinson disorders and other neurological diseases].
On the basis of six randomized controlled trials, zonisamide (ZNS) can be prescribed as add-on treatment in focal adulthood epilepsy in USA and Europe. In Japan, it can be prescribed as first-line monotherapy drug - independent of age. ZNS may also be effective in idiopathic generalized epilepsy and some difficult-to-treat epilepsies including West, Lennox-Gastaut, or Dravet syndromes. The most frequent side effects of ZNS are related to central nervous system occurring in 19%. Kidney stones and oligohidrosis are ZNS-specific side effects. Loss of appetite and weight are usually "beneficial" effects. ZNS is not recommended in pregnancy ZNS can be taken once daily, which may be beneficial in non-compliance. The pathomechanism of ZNS is different from other antiepileptic drugs. ZNS has an effect on the voltage-gated Na+ - and T-type Ca2+ channels as well as on the dopaminerg, glutamaterg, cholinerg, and GABAerg systems. The multiple way of action may be the reason why ZNS seems to be a broad-spectrum drug and beneficial in various neurological disorders. ZNS reduces production of free radicals according to in vitro and in vivo studies. Animal experiments suggest that ZNS may be a neuroprotective agent. Based on an adequate randomized controlled trial, ZNS is effective in adjuctive treatment of Parkinson disorder. A peculiar benefit of the ZNS is that parallel to its positive effect on motor impairment it also reduces severity of dyskinesias. ZNS may be effective in bipolar disorder, obesity, eating disorders, and migraine prophylaxis.
Janszky
József
J
Pécsi Tudományegyetem, Altalános Orvostudományi Kar, Neurológiai Klinika, Pécs. janszky@index.hu
D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy; D020747:Calcium Channels, T-Type / Q000187:drug effects; D018678:Cholinergic Agents / Q000494:pharmacology / Q000627:therapeutic use; D015259:Dopamine Agents / Q000494:pharmacology / Q000627:therapeutic use; D020820:Dyskinesias / Q000188:drug therapy; D004827:Epilepsy / Q000188:drug therapy*; D018683:Excitatory Amino Acid Agents / Q000494:pharmacology / Q000627:therapeutic use; D001068:Feeding and Eating Disorders / Q000188:drug therapy; D018682:GABA Agents / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000517:prevention & control; D009419:Nerve Tissue Proteins / Q000187:drug effects; D009422:Nervous System Diseases / Q000188:drug therapy*; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D009765:Obesity / Q000188:drug therapy; D010300:Parkinson Disease / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D015222:Sodium Channels / Q000187:drug effects; D016896:Treatment Outcome; D062548:Voltage-Gated Sodium Channel beta-2 Subunit; D000078305:Zonisamide
D000927:Anticonvulsants; D020747:Calcium Channels, T-Type; D018678:Cholinergic Agents; D015259:Dopamine Agents; D018683:Excitatory Amino Acid Agents; D018682:GABA Agents; D007555:Isoxazoles; D009419:Nerve Tissue Proteins; D018696:Neuroprotective Agents; C117620:SCN2B protein, human; D015222:Sodium Channels; D062548:Voltage-Gated Sodium Channel beta-2 Subunit; D000078305:Zonisamide