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Update on once-daily zonisamide monotherapy in partial seizures

Authors Afra P, Adamolekun B

Received 2 December 2013

Accepted for publication 28 January 2014

Published 19 March 2014 Volume 2014:10 Pages 493—498


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Pegah Afra,1 Bola Adamolekun2

1Department of Neurology, School of Medicine, University of Utah, Salt Lake City, UT, 2Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA

Abstract: Zonisamide is an antiepileptic drug that is structurally different from other antiepileptic agents. Its long half-life, once-daily dosing, lack of induction of hepatic enzymes, and broad spectrum of action makes it a suitable candidate for monotherapy. It has been approved as monotherapy for partial onset epilepsy in Japan and South Korea for more than a decade, and was recently approved as monotherapy in Europe. In the USA, it is only approved by the US Food and Drug Administration for adjunctive treatment of partial onset epilepsy. In this paper, we briefly review the literature on zonisamide monotherapy in partial onset epilepsy with regard to its efficacy, safety, tolerability, and long-term side effects, including a recent noninferiority trial in comparison with extended-release carbamazepine. While European regulatory agencies use noninferiority trials for approval of monotherapy, such a trial design does not meet the current regulatory requirements for approval as monotherapy in the USA.

Keyword: zonisamide, Zonegran, monotherapy

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