Abstracts

RATIONALE: Extended clinical experience with zonisamide monotherapy has been very limited and usually restricted to tertiary referral centers. We report our experience in patients, with follow-up to 1 year, who presented for consultation to the neurology department of a large multi-group clinic.
METHODS: We reviewed the charts of patients given zonisamide as monotherapy at the Kelsey-Seybold Clinic, Houston, Texas, from 4/01/01 and 3/31/02.
RESULTS: Group 1 with patients naive to AEDs (7 with primary generalized seizures, 7 with partial seizures) had treatment initiated with zonisamide; 12 remain on the agent (follow-up 2-11months). Two patients required change of treatment because of untoward effects or seizures. Daily dosage ranged from 50 to 200 mg/day in the 7 female and 7 male patients, ages from 12 to 56. 12 patients remain seizure free, 3 with follow-up of greater than 6 months. Group 2, with 33 patients, had treatment changed to zonisamide monotherapy from another agent. 15 had partial and 18 had generalized seizures. Doses ranged from 50 to 300 mg/day. 22 patients remained on monotherapy (follow-up 1-12 months). 6 patients required a second agent for seizure control; 3 changed to a different AED because of an untoward effect (1), to lose weight (1), seizure recurrence (1). Two patients discontinued zonisamide against medical advice. 11 patients have remained seizure free for greater than 6 months and one has remained seizure free for over 1 year.
CONCLUSIONS: We conclude that zonisamide is effective and tolerated in a large percentage of patients with multiple seizure types. The dosage range in patients with monotherapy appears lower than in reported doses required in add-on studies.
[Supported by: Bob and Vivian Smith Foundation]