Update on once-daily zonisamide monotherapy in partial seizures

Area of Science:

• Neurology
• Pharmacology

Background:

• Zonisamide is a unique antiepileptic drug (AED) with favorable pharmacokinetic properties.
• Its potential for monotherapy in partial onset epilepsy is recognized globally.

Purpose of the Study:

• To review the efficacy, safety, and tolerability of zonisamide monotherapy for partial onset epilepsy.
• To compare zonisamide monotherapy with other AEDs, including extended-release carbamazepine.

Main Methods:

• Literature review of studies on zonisamide monotherapy.
• Inclusion of data from a recent noninferiority trial comparing zonisamide with extended-release carbamazepine.

Main Results:

• Zonisamide demonstrates suitability for monotherapy due to its long half-life and broad spectrum of action.
• Regulatory approvals for zonisamide monotherapy differ between the USA, Europe, Japan, and South Korea.

Conclusions:

• Zonisamide is a viable option for monotherapy in partial onset epilepsy.
• Regulatory standards, such as noninferiority trial designs, influence AED approval pathways worldwide.