Zonegran

(zonisamide, Elan Pharmaceuticals)

An adjunctive antiseizure drug for people 16 and over with partial seizures.

* Recommended Dosage: Starting at 100 mg/day; increasing dose at 2-week intervals up to 400 mg a day, if necessary.

* Special Considerations: The most common side effects included somnolence, anorexia, dizziness, and nausea. Zonegran is a sulfonamide, so warnings regarding potentially fatal reactions to sulfonamides apply About 2%-3% of treated patients develop kidney stones; risk apparently greater in those with a family history. Women who can become pregnant should use effective contraception.

* Comment: In 12-week trials of patients with refractory partial-onset seizures, the mean reduction in the frequency of these seizures ranged from 27% to 40.5% among those treated with Zonegran, significantly better than the 9% seen among subjects on placebo in one study, and slight increases in the two other studies.

Dr. Steven C. Schachter, director of the comprehensive epilepsy program at Harvard University, said that in the field of epilepsy therapy, "the most pressing need is for new drugs that are effective for partial seizure," the most common seizure in adults. Dr. Schachter is an investigator for studies conducted by Elan, but not for those that led to Zonegran's approval.

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