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Zonisamide add-on for drug-resistant partial epilepsy.
1Department of Neurological Science, Room 2.26 - Clinical Science Centre for Research & Education, Lower Lane, Liverpool, Merseyside, UK, L9 7LJ. p.bessant@liv.ac.uk
The Cochrane Database of Systematic Reviews
|June 22, 2002
Summary
Zonisamide is effective as an add-on treatment for drug-resistant partial epilepsy, significantly reducing seizure frequency. However, optimal dosing and long-term effectiveness require further investigation.
Area of Science:
- Neurology
- Pharmacology
Background:
- Up to 30% of epilepsy patients develop refractory epilepsy, particularly those with partial seizures.
- Zonisamide is an antiepileptic agent evaluated for add-on therapy in drug-resistant cases.
Purpose of the Study:
- To evaluate the efficacy and safety of zonisamide as an add-on treatment for drug-resistant partial epilepsy.
Main Methods:
- Systematic review of randomized placebo-controlled add-on trials of zonisamide.
- Searched Cochrane Epilepsy Group and Cochrane Controlled Trials Register, contacted manufacturers and experts.
- Included three trials with 499 participants; analyzed seizure frequency reduction, treatment withdrawal, and adverse events.
Main Results:
- Zonisamide (400mg/day) showed a significant odds ratio (OR) of 2.07 for a 50% seizure reduction compared to placebo (95% CI 1.36 to 3.15).
- Overall OR for 50% seizure reduction across trials was 2.72 (95% CI 1.74 to 4.25).
- Associated adverse events included ataxia, somnolence, agitation, and anorexia.
Conclusions:
- Zonisamide demonstrates efficacy as an add-on therapy for drug-resistant partial epilepsy.
- Minimum effective and maximum tolerated doses were not identified.
- Trial duration was limited to 12 weeks, precluding assessment of long-term effectiveness.