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Comparative trial of low- and high-dose zonisamide as monotherapy for childhood epilepsy

Authors
 So-Hee Eun ; Heung Dong Kim ; Han Ku Moon ; Joon Soo Lee ; Soyong Eom ; Dong Wook Kim ; Eun Sook Suh ; Young-Mock Lee ; Hoon-Chul Kang ; Joon Sik Kim ; Hee Jung Chung ; In Kyu Lee ; Baik-Lin Eun 
Citation
 Seizure - European Journal of Epilepsy, Vol.20(7) : 558~563, 2011 
Journal Title
 Seizure - European Journal of Epilepsy 
ISSN
 1059-1311 
Issue Date
2011
Abstract
PURPOSE: To evaluate the effectiveness of zonisamide (ZNS) as monotherapy in children with newly diagnosed epilepsy. METHODS: This randomized, multicenter trial included a 2-4-week titration and a 24-week maintenance phase after randomization to low-(3-4 mg/kg/day) or high-(6-8 mg/kg/day) dose groups as target maintenance dosages. The primary outcome measure was the seizure-free rate over 6 months, while a secondary measure was the change in cognition and behavior from screening to the end of the maintenance phase. RESULTS: Out of 125 patients enrolled, 90 (49 low-dose and 41 high-dose) completed the study. Forty-one patients (63.1%) in the low-dose group and 34(57.6%) in the high-dose group achieved 6 months' freedom from seizures (p=0.66). After treatment, the picture arrangement subtest improved in the low-dose group (p=0.047) while the vocabulary subtest worsened in the high-dose group (p=0.020). Comparing between the two groups, the vocabulary subtest in the high-dose group was significantly worse than that in the low-dose group (p=0.002). Social competence, somatic complaints, depression/anxiety and delinquent and aggressive behavior in the low-dose group were significantly improved (p<0.05). Moreover, total social competence, somatic complaints, delinquent behavior, externalizing, and total behavior problems were significantly more improved in the low-dose group than the high-dose group (p<0.05). CONCLUSIONS: ZNS is an effective monotherapy for newly diagnosed childhood epilepsy. Lower doses of ZNS have a similar efficacy and more beneficial neurocognitive effects compared to higher doses. When prescribing higher doses of ZNS, one must be aware of the possible manifestation of problems associated with language development, such as those affecting vocabulary acquisition.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93726
DOI
10.1016/j.seizure.2011.04.005
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Pediatrics
1. 연구논문 > 1. College of Medicine > Dept. of Psychiatry
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S1059131111001087
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