Oral
zonisamide (
Zonegran(®)) is a benzisoxazole derivative chemically unrelated to other
antiepileptic agents. It is indicated in the EU as monotherapy in the treatment of
partial seizures, with or without secondary generalization, in adults with newly diagnosed
epilepsy and as adjunctive
therapy to other
antiepileptic drugs (AEDs) in the treatment of adults with
partial seizures, with or without secondary generalization. In a double-blind, multinational study in adults newly diagnosed with
partial seizures, shorter-term monotherapy with once-daily
zonisamide was noninferior to that with twice-daily
carbamazepine controlled release in terms of seizure freedom according to the International League Against
Epilepsy guidelines, with seizure freedom benefits maintained during longer-term
therapy. In four randomized, double-blind, placebo-controlled studies in adults with refractory
partial seizures, shorter-term adjunctive
therapy with once- or twice-daily
zonisamide reduced the frequency of
seizures to a significantly greater extent than placebo, with
antiepileptic efficacy sustained following longer-term treatment in this patient population.
Zonisamide was generally well tolerated in adults with
partial seizures participating in these studies, with the majority of adverse events being mild or moderate in severity. Thus, oral
zonisamide as monotherapy or adjunctive
therapy to other AEDs provides a useful option in the treatment of patients with
partial seizures.