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Zonisamide and associated oligohidrosis and hyperthermia.
Phillip A Low1, Steven James, Tobias Peschel
1Department of Neurology, Mayo Clinic College of Medicine, 811 Guggenheim Building, Rochester, MN 55905, USA. low@mayo.edu
Epilepsy Research
|November 3, 2004
Summary
Zonisamide, an antiepileptic drug, can cause decreased sweating (oligohidrosis) and heat stroke, especially in children during summer. Symptoms are reversible upon stopping the medication.
Area of Science:
- Pharmacology
- Neurology
- Pediatrics
Background:
- Zonisamide is an antiepileptic agent used for partial seizures.
- Oligohidrosis and hyperthermia are potential adverse events associated with zonisamide use.
- The exact mechanism of zonisamide-induced oligohidrosis remains unclear.
Purpose of the Study:
- To report cases of zonisamide-associated oligohidrosis and hyperthermia.
- To analyze the incidence and patient demographics of these adverse events.
- To provide recommendations for managing zonisamide-associated hyperthermia.
Main Methods:
- Review of adverse event reports in the US and Japan.
- Calculation of incidence rates for oligohidrosis and hyperthermia.
- Analysis of patient characteristics, particularly age and seasonality.
Main Results:
- Thirteen events of oligohidrosis or hyperthermia reported in the US within 3 years of approval (incidence: 1 per 4590 patient-years).
- All reported cases in Japan were in children (incidence: 1 per 10,000 pediatric-years over 11 years).
- Oligohidrosis was reversible upon zonisamide discontinuation in all cases.
Conclusions:
- Zonisamide can cause oligohidrosis, potentially leading to hyperthermia, predominantly in pediatric patients.
- Hyperthermia risk is higher during hot weather, emphasizing the need for hydration and cooling measures.
- Discontinuation of zonisamide effectively reverses oligohidrosis.