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Zonisamide in the management of epilepsy in the elderly

Authors Romigi A, Femia EA, Fattore C, Vitrani G, Di Gennaro G, Franco V

Received 12 December 2014

Accepted for publication 10 April 2015

Published 8 June 2015 Volume 2015:10 Pages 931—937

DOI https://doi.org/10.2147/CIA.S50819

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker

Andrea Romigi,1,2 Eti A Femia,3 Cinzia Fattore,4 Giuseppe Vitrani,1 Giancarlo Di Gennaro,1 Valentina Franco4

1Istituto Neurologico Mediterraneo, IRCCS Neuromed, Pozzilli (IS), Italy; 2Neurophysiopathology Department, University of Rome Tor Vergata, Rome, Italy; 3Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; 4Clinical Trial Centre & Antiepileptic Drugs, C. Mondino National Neurological Institute, Pavia, Italy

Abstract: Zonisamide (ZNS), a second-generation antiepileptic drug, indicated as add-on treatment of focal epilepsy, has been recently approved as monotherapy for the treatment of partial seizures in adults affected by newly diagnosed epilepsy in Europe. Evidence on the efficacy and tolerability of antiepileptic drugs in the elderly is still lacking as these patients are frequently excluded from clinical trials. Here, a comprehensive overview of available data regarding the use of ZNS in the treatment of epilepsy in elderly people is provided. In a pooled analysis conducted in patients aged ≥65 years, no new/unexpected safety findings have emerged. Few data from uncontrolled investigations suggest that ZNS may be effective and well tolerated when administered as monotherapy or adjunctive antiepileptic treatment in the elderly. However, evidence from these observational studies is less than satisfactory, and randomized controlled trials focused on these patients are still needed.

Keywords: zonisamide, elderly, epilepsy, safety, efficacy

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