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Zonisamide for essential tremor.

Elisa Bruno1, Alessandra Nicoletti, Graziella Filippini

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|August 25, 2017
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This summary is machine-generated.

Zonisamide shows uncertain efficacy for essential tremor (ET). Limited data indicates potential adverse events like headache and nausea, with insufficient evidence to confirm its safety or effectiveness as an ET treatment alternative.

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Area of Science:

  • Neurology
  • Movement Disorders
  • Pharmacology

Background:

  • Essential tremor (ET) is a common movement disorder with limited treatment options.
  • Current treatments like primidone and propranolol are ineffective for a significant patient subset and can cause adverse events.
  • Zonisamide is a potential alternative, but its efficacy and safety for ET require further investigation.

Purpose of the Study:

  • To evaluate the functional impact and safety profile of zonisamide in adult patients diagnosed with essential tremor (ET).

Main Methods:

  • A systematic literature search was conducted across multiple databases (CENTRAL, MEDLINE, Embase, etc.) up to January 2017.
  • Included were randomized controlled trials (RCTs) comparing zonisamide to placebo or other treatments for ET, adhering to validated diagnostic criteria.
  • Data extraction, risk of bias assessment, and meta-analysis (using Review Manager 5) were performed by two independent reviewers.

Main Results:

  • Only one RCT with 20 participants met the inclusion criteria, yielding very low-quality evidence.
  • Zonisamide demonstrated no significant effect on motor tasks (MD -0.00, 95% CI -1.51 to 1.51) or functional disabilities (MD -0.30, 95% CI -1.23 to 0.63) compared to placebo.
  • Adverse events, including headache, nausea, and fatigue, were more frequent in the zonisamide group (60%) than placebo (0%), with a significant risk difference (RD 0.60, 95% CI 0.28 to 0.92).

Conclusions:

  • Current evidence is insufficient to determine the efficacy and safety of zonisamide for treating essential tremor (ET).
  • Further high-quality randomized controlled trials are needed to establish zonisamide's role in ET management.