title: Zonisamide: Review of Recent Clinical Evidence for Treatment of Epilepsy.
abstract: Zonisamide is an orally administered antiepileptic drug that was first approved for clinical use in Japan in 1989. Since then, it has been licensed in Korea for a broad spectrum of epilepsies in adults and children, and in the USA for adjunctive therapy of adults with partial seizures, and in Europe for monotherapy of adults with newly diagnosed partial seizures and adjunctive therapy of adults and adolescents and children aged ≥6 years with partial seizures with or without secondary generalization. Zonisamide is a benzisoxazole derivative with a unique chemical structure, predictable dose-dependent pharmacokinetics, and multiple complementary mechanisms of action. Treatment with zonisamide is well tolerated and is not known to be associated with clinically significant drug-drug interactions, including with oral contraceptives or other antiepileptic drugs. There have been >2 million patient-years of experience with zonisamide for treatment of epilepsy, and this drug has International League Against Epilepsy level A evidence for efficacy/effectiveness as initial monotherapy for adults with partial-onset seizures. This review presents the evidence for zonisamide across the spectrum of epilepsy, with emphasis on real-world clinical practice and special populations of patients (children, elderly patients, and women of childbearing age) who are likely to be treated in daily clinical practice.
authors.affiliation: Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shang-Yeong
authors.initials: SY
authors.lastname: Kwan
authors.affiliation: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yao-Chung
authors.initials: YC
authors.lastname: Chuang
authors.affiliation: National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Chin-Wei
authors.initials: CW
authors.lastname: Huang
authors.affiliation: Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Ta-Cheng
authors.initials: TC
authors.lastname: Chen
authors.affiliation: Macky Memorial Hospital, Taipei, Taiwan.
authors.forename: Shuo-Bin
authors.initials: SB
authors.lastname: Jou
authors.affiliation: Eisai Co. Ltd, Mumbai, India.
authors.forename: Amitabh
authors.initials: A
authors.lastname: Dash
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide
keywords: Anticonvulsants; Epilepsies; Epilepsy; Generalized; Partial; Seizures; Zonisamide