title: [ZONISAMIDE: FIRST CHOICE AMONG THE FIRST-LINE ANTIEPILEPTIC DRUGS IN FOCAL EPILEPSY].
abstract: Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term 'epilepsy' which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level "A") as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient's compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.
authors.forename: József
authors.initials: J
authors.lastname: Janszky
authors.forename: Réka
authors.initials: R
authors.lastname: Horvath
authors.forename: Sámuel
authors.initials: S
authors.lastname: Komoly
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D004334:Drug Administration Schedule; D017277:Drug Approval; D011307:Drug Prescriptions / Q000592:standards*; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006814:Hungary; D007555:Isoxazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D000077287:Levetiracetam; D008279:Magnetic Resonance Imaging; D055118:Medication Adherence; D009765:Obesity / Q000150:complications; D010672:Phenytoin / Q000627:therapeutic use; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D012640:Seizures / Q000517:prevention & control*; D020521:Stroke / Q000150:complications; D015431:Weight Loss / Q000187:drug effects; D055815:Young Adult; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D007555:Isoxazoles; D002220:Carbamazepine; D000077287:Levetiracetam; D000078305:Zonisamide; D010672:Phenytoin; D010889:Piracetam