Stephen, L.J., Kelly, K., Wilson, E., Parker, P. and Brodie, M. (2010) A prospective audit of adjunctive zonisamide in an everyday clinical setting. Epilepsy and Behavior, 17(4), pp. 455-460. (doi: 10.1016/j.yebeh.2010.01.016)
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Abstract
This audit examined outcomes for 203 patients prescribed zonisamide (ZNS) for various uncontrolled seizure types at a specialist outpatient service. Forty-two (20.7%) patients achieved 6 months of seizure freedom, and an additional 37 (18.2%) had a >= 50% seizure reduction for 6 months on a stable ZNS dose. Seizure freedom was more likely in patients with primary generalized (24/61, 39%) than in those with partial-onset (18/141, 12.7%) seizures (P < 0.001). Eight patients (5 seizure free) were maintained on ZNS monotherapy. More patients became seizure free with ZNS as monotherapy or first add-on, compared with those in whom ZNS was the second, third, or fourth adjunctive drug (P = 0.001). Seizure freedom was less likely in patients treated with hepatic enzyme-inducing agents (13/113, 11.5%) than in those receiving noninducing AEDs (24/82, 29.3%) (P = 0.002). ZNS was discontinued in 72 (35.5%) patients largely because of side effects (n = 58, 28.6%). Commonest complaints leading to withdrawal were sedation (n = 14), nausea and vomiting (n = 13), neuropsychiatric symptoms (n = 12), rash (n = 6), and weight loss (n = 6). Around 80% of patients who became seizure free on ZNS or had the drug withdrawn did so on a dose <= 200 mg. ZNS is an effective broad-spectrum AED that can also produce a range of dose-dependent and idiosyncratic side effects. (C) 2010 Elsevier Inc. All rights reserved
| Item Type: | Articles |
|---|---|
| Keywords: | AGENTS Antiepileptic drug Antiepileptic drugs audit BRAIN CNS EFFICACY Epilepsy EXPERIENCE LANDAU-KLEFFNER-SYNDROME LEVETIRACETAM MONOTHERAPY neurology outcome OUTCOMES PARTIAL SEIZURES PATIENT patients Prospective REDUCTION REFRACTORY EPILEPSY SAFETY Scotland Seizure SEIZURES Side effects SYMPTOMS TOLERABILITY UNIT weight WEIGHT-LOSS Zonisamide |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Stephen, Dr L |
| Authors: | Stephen, L.J., Kelly, K., Wilson, E., Parker, P., and Brodie, M. |
| College/School: | College of Medical Veterinary and Life Sciences |
| Journal Name: | Epilepsy and Behavior |
| ISSN: | 1525-5050 |
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