Related Experiment Video
Updated: Jun 3, 2026
08:36
Neurotoxicity Assessment in Adult Danio rerio using a Battery of Behavioral Tests in a Single Tank
Published on: November 3, 2023
Moderate toxic effects following acute zonisamide overdose
Katharina E Hofer1, Christian Trachsel, Christine Rauber-Lüthy
1Swiss Toxicological Information Centre, Zurich, Switzerland.
Epilepsy & Behavior : E&B
|April 6, 2011
Summary
This study reports the first case of zonisamide mono-intoxication. Even with a large overdose, patients can achieve complete recovery with supportive care.
Area of Science:
- Pharmacology
- Clinical Toxicology
Background:
- Zonisamide is an antiepileptic drug used for partial seizures.
- Common side effects include somnolence, anorexia, dizziness, and headache.
- Limited data exist on zonisamide overdose, with no published cases of mono-intoxication.
Observation:
- A 25-year-old woman ingested 12.6 g of zonisamide with suicidal intent.
- She presented with a plasma zonisamide concentration of 182 mg/L.
- Clinical course included vomiting, central nervous system depression, and brief intubation.
Findings:
- The patient experienced somnolence for 50 hours.
- Normal-anion-gap metabolic acidosis and polyuria were observed for several days.
- Despite the large overdose, the clinical course was benign.
Implications:
- Complete recovery is possible with supportive care, even in cases of significant zonisamide overdose.
- This case expands the understanding of zonisamide toxicity and overdose management.
- Highlights the importance of supportive measures in managing antiepileptic drug overdoses.
Related Concept Videos
01:24Drug Toxicity: Dose-Dependent Reactions
Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
01:00Drug Toxicity: Overview
Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
01:20Antiepileptic Drugs: Potassium Channel Activators
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
01:16Drug toxicity: Idiosyncratic Reactions
Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
01:24Drug Toxicity: Risk factors
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
01:30Toxidromes: Clinical Features
Toxidromes are specific patterns of symptoms resulting from toxic substance exposure. They help in the identification and treatment of poisoning. The symptoms of each toxidrome group indicate poisoning by a certain class of chemicals or drugs.1. Sympathomimetic: Stimulates the sympathetic nervous system. Symptoms include agitation, increased heart rate (HR), blood pressure (BP), respiratory rate (RR), temperature, and pupil size. Drugs like cocaine and amphetamines, along with tremors and...