Anorexia zonisamide

The most commonly observed adverse events associated with the use of zonisamide were agitation/irritability, anorexia, dizziness, headache, nausea, and somnolence. 

In a large Japanese survey, adverse effects occurred in 51% of patients treated with zonisamide and led to drug withdrawal in 18%. The most common were drowsiness, ataxia, anorexia, mental slowing, and gastrointestinal symptoms (2). Other adverse effects include dizziness, nystagmus, dysarthria, diplopia, asterixis, tremor, confusion, anorexia, and weight loss. Some of these may be related to the rate of dosage escalation. 

In a double-bUnd, placebo-controUed, add-on, randomized trial of zonisamide 400 mg/day in 203 patients over 14 years of age with refractory partial-onset seizures, the response rate was 42% (3). The most common treatment-emergent adverse events were somnolence, anorexia, rhinitis, dizziness, nausea or vomiting, ataxia, fatigue, and headache. With zonisamide, 22% of the patients lost over 2.3 kg compared with 10% on placebo. 

TOXICITY Zonisamide is well tolerated. Adverse effects include somnolence, ataxia, anorexia, nervousness, and fatigue. Approximately 1% of individuals develop renal calculi during treatment with zonisamide, probably related to its ability to inhibit carbonic anhydrase. 

In 22 out-patients with alcohol dependence, who took zonisamide 50 mg/day titrated to a maximum dose of 300 mg/day in an open study [369 ] there was only one dropout due to an adverse event (dizziness). Adverse reactions reported during the study included weight loss (n = 18), anorexia (n = 2), sleepiness (n = 2), and dizziness ( = 1). 

In the first study, 25 subjects had treatment-emergent adverse effects. Those that were considered to be possibly or probably related to zonisamide were fatigue (n = 2), abdominal pain (n = 2), and weakness, dry lips, nausea, anorexia, oral paresthesia, and back pain (one each). In the second study, 21 subjects had treatment-emergent adverse effects and those that were considered to be possibly or probably related to zonisamide were dizziness ( = 3), nausea (n = 2), increased serum creatinine... 

Observational studies The safety and efficacy of zonisamide for intractable focal epilepsy were investigated in 121 Korean patients taking a dose of 200 mg/day. The most common adverse events were dizziness (28.1%), somnolence (24.0%), anorexia (18.2%), headache (14%), nausea (13.2%), and weight loss (10.7%) [203 ]. 

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