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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by undopaminergic on June 3, 2008, at 23:10:13
I haven't read of anyone using zonisamide (Zonegran). I'd be interested in user experience with this drug. In any case, this message may generate some interest in a neglected treatment that may be of great utility in some conditions.
Zonisamide is medicine primarily employed in the treatment of epilepsy. It was introduced in the late 80s in some countries, and decades later in some other places. Zonisamide has no relationship to other contemporary anticonvulsants, although its clinical profile has some resemblance to that of carbamazepine and oxcarbazepine.
Those having limited success in their efforts to lose weight, and those experiencing drug-induced weight gain, may be particularly interested in a trial of zonisamide. Zonisamide has been found effective for weight reduction in obese patients, and prevents the elevation of weight and blood glucose by olanzapine-treatment in rats - which suggests that it may be of particular value to Zyprexa users.
Like other anticonvulsants, zonisamide can be useful in bipolar disorders for the treatment of both manic and depressive episodes. While it is a terrific solution for some bipolar patients, many of them discontinue it rapidly due to a worsening of the depressive or manic condition, or other adverse effects.
Zonisamide can be an excellent alternative in the treatment of essential tremor, as many patients tolerate it better than the conventional agents of choice for the condition - propranolol and primidone.
Like many other anticonvusants, zonisamide has been found to have significant analgesic efficacy in some conditions of neuropathic pain.
Some of the less extensively documented uses for zonisamide are in migraine prevention, and in anxiety refractory to conventional drugs.
However, by far the most interesting aspect of zonisamide is its poorly understood dopaminergic properties, including a pronounced effect on the symptoms of Parkinson's disease, which has been confirmed by at least one double-blind placebo-controlled trial.
Chronic - but not acute - treatment with zonisamide leads to an upregulation of tyrosine hydroxylase and enhanced synthesis of dopamine.
As a bonus, zonisamide seems to have not only serotonin-enhancing properties as well, but also increases acetylcholine levels. However, excessive doses may instead produce a reduction of the three neurotransmitters discussed (dopamine, serotonin, and acetylcholine - I haven't found any data on zonisamide's adrenergic effects, if any).
Posted by SLS on June 4, 2008, at 4:52:38
In reply to Zonisamide - any experiences?, posted by undopaminergic on June 3, 2008, at 23:10:13
Hi Undopaminergic.
I tried taking Zonegran about 3 years ago. I found it to be "clean" cognitively and weight neutral. It didn't help. I was taking it as an adjunct to a combination of Effexor and nortriptyline. My case has been extraordinarily severe and chronic. It is not a good idea to use my case as representative of the majority. Of course, I doubt many of our cases are.
I did find Zonegran a bit energizing.
- Scott
Posted by Nadezda on June 4, 2008, at 10:43:11
In reply to Re: Zonisamide - any experiences?, posted by SLS on June 4, 2008, at 4:52:38
Are you saying it's neglected mostly in the treatment of bipolar disorder, and possibly neuropathic or chronic pain (as well as weight-loss, and possible energizing effects, etc)?
I wanted to pinpoint the areas where you thought it had been shown to have possible value.
Thanks,
Nadezda
Posted by ClearSkies on June 4, 2008, at 11:11:14
In reply to Zonisamide - any experiences?, posted by undopaminergic on June 3, 2008, at 23:10:13
I take Zonisamide as a prophylactic daily treatment for migraine headaches. It has been a weight neutral medication for me and has had no effect that I can detect on my mood. It's works a charm, though, on keeping my migraines at bay.
That's 75mg twice daily. I've been on it for over a year, and have had probably three headaches since starting taking it - a miracle for me.ClearSkies
Posted by undopaminergic on June 5, 2008, at 4:41:55
In reply to Re: Zonisamide - any experiences?, posted by Nadezda on June 4, 2008, at 10:43:11
> Are you saying it's neglected mostly in the treatment of bipolar disorder, and possibly neuropathic or chronic pain (as well as weight-loss, and possible energizing effects, etc)?
>I meant that it seems to be neglected in psychiatry and disorders other than epilepsy.
This is the end of the thread.
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