zonisamide / Generic mfg. - LARVOL DELTA

Beyond the classic ketogenic diet: A systematic review of alternative and adjunctive therapies for GLUT1 deficiency syndrome. (PubMed, Epilepsy Res) - "While CKD remains the reference standard for GLUT1-DS management, selected alternative and adjunctive therapies may offer clinically meaningful benefit in specific clinical contexts. The current evidence base, however, is limited. These findings support cautious and individualized use of alternative therapeutic strategies while highlighting the need for larger prospective studies and standardized outcome measures to better define their role in GLUT1-DS management."

Journal • Review • CNS Disorders • Epilepsy • Metabolic Disorders • Movement Disorders • Pediatrics • SLC2A1

Efficacy and Tolerability of Zonisamide for Alcohol Use Disorder: A Systematic Review and Meta-Analysis. (PubMed, J Clin Psychopharmacol) - "Zonisamide reduced drinks per day and drinking days but not heavy drinking days, suggesting a selective benefit on overall consumption. A protective effect on nervousness, anxiety, and irritability was also observed, consistent with zonisamide's GABAergic mechanism. Further well-powered trials are needed to inform clinical recommendations."

Journal • Retrospective data • Addiction (Opioid and Alcohol) • Mood Disorders • Psychiatry

Trends in Use of Antiseizure Medicines in Women With Epilepsy in Pregnancy During 2018-2023 in an Irish Maternity Hospital: A Cohort Study. (PubMed, Obstet Gynecol Int) - "Levetiracetam (60.1%) and lamotrigine (31.5%) were most frequently used overall. Zonisamide use decreased significantly (-0.395, p = 0.029), although this finding should be interpreted cautiously given the small number of exposures (n = 13)...ASMs with safer pregnancy profile were most frequently used in WWE in pregnancy. Additional data are needed to further assess trends and outcomes and to determine the place of newer generation ASMs in WWE in pregnancy."

Journal • CNS Disorders • Epilepsy

Potential Role of CYP3A4 in Determining In Vivo Exposure to Cannabidiol (CBD) and its Active Metabolite 7-OH-CBD: Evidence from an In Vitro Study. (PubMed, Eur J Drug Metab Pharmacokinet) - "ASMs with CYP3A4-inhibitory potential may alter systemic exposure to both CBD and its active metabolite, 7-OH-CBD, as demonstrated in vitro. However, co-administration of CBD with CYP3A4-substrate ASMs or CYP2C19 inhibitors is predicted to result in only modest increases in CBD exposure."

Journal • Preclinical • CNS Disorders • Epilepsy • CYP2C19 • CYP2C9 • CYP3A4

Therapeutic drug monitoring of zonisamide in children with epilepsy: development and validation of a precise binary prediction model. (PubMed, Front Pharmacol) - "Sex, liver and kidney function, and nutrition-related indices collectively modulate the processes of drug absorption, metabolism, and clearance, thereby influencing the risk of failing to achieve target concentrations. The machine learning prediction model constructed using the CART algorithm can accurately and stably predict whether steady-state trough concentrations of zonisamide reach the target therapeutic range in pediatric patients with epilepsy."

Journal • CNS Disorders • Epilepsy • Pediatrics

Zonisamide attenuates morphine tolerance in association with reduced spinal TLR4/p38 MAPK signaling. (PubMed, Front Pharmacol) - "Pharmacological inhibition of TLR4 with TAK-242 was used to verify the involvement of TLR4 signaling. These findings indicate that zonisamide attenuates morphine tolerance in association with reduced spinal TLR4/p38 MAPK signaling and neuroinflammation. This study provides a mechanistic rationale for repurposing zonisamide as an adjunct therapy to improve long-term pain management and mitigate opioid-related adverse effects."

IO biomarker • Journal • Inflammation • Oncology • Pain • IL1B • IL6 • TLR4 • TNFA

Cognitive Side Effects of Antiseizure Medications in Adults with Epilepsy: An Update with a Focus on New Therapeutic Agents. (PubMed, CNS Drugs) - "Overall, newer-generation ASMs, including rufinamide, lacosamide, brivaracetam, cannabidiol, fenfluramine, and ganaxolone, demonstrate generally favourable cognitive profiles when used at recommended doses, particularly in monotherapy or rational polytherapy. Eslicarbazepine and cenobamate may be associated with mild, dose-dependent cognitive effects, occurring only at the upper end of the recommended dose range. In contrast, old ASMs and certain second-generation agents, notably topiramate and zonisamide, remain consistently associated with higher cognitive risks...Cognitive dysfunction in epilepsy is multifactorial, reflecting the interaction between disease-related neurobiological mechanisms and treatment effects. Optimal management requires balancing seizure control with cognitive preservation through individualised drug selection, cautious titration, and minimisation of polytherapy to achieve the best functional and quality-of-life outcomes."

Adverse events • Journal • Review • CNS Disorders • Cognitive Disorders • Developmental Disorders • Epilepsy • Mental Retardation

Recurrent Neurologic Signs After Hemodialysis for Phenobarbital and Zonisamide Intoxication in a Dog. (PubMed, J Vet Emerg Crit Care (San Antonio)) - "This is the first report documenting the occurrence of redistribution phenomenon in a patient undergoing extracorporeal removal of toxins. In addition, this is the first case report documenting the use of hemodialysis to treat zonisamide toxicosis."

Journal • CNS Disorders • Epilepsy

Case Report: SMART syndrome mimicking Todd's paralysis after meningioma irradiation. (PubMed, Front Oncol) - "Following multidisciplinary evaluation, the patient required a prolonged dexamethasone taper due to failed initial steroid taper and was initiated on amlodipine with continuation of levetiracetam, zonisamide, and clobazam. MRI at three months showed enhancement resolution with clinical improvement and no recurrent seizures. This case highlights SMART syndrome as a diagnosis of exclusion, notable for its shortened latency in comparison to the reported mean and rare association with meningioma, emphasizing the need for heightened clinical suspicion in patients with prior cerebral irradiation presenting with progressive neurologic deficits."

Journal • Brain Cancer • Cardiovascular • CNS Disorders • Epilepsy • Glioma • Medulloblastoma • Meningioma • Migraine • Oncology • Pain • Solid Tumor

Speech-Induced Myoclonus-Dystonia Mimicking Stuttering and Responding to Zonisamide. (PubMed, Ann Indian Acad Neurol) - "It may mimic stuttering, and detailed analysis of the phenomenology and the evaluation of family history may help establish the diagnosis. A trial of zonisamide may be considered in the treatment of this disabling condition."

Journal • CNS Disorders • Dystonia • Movement Disorders

Zonisamide Improves Cognitive Impairment and Psychiatric Symptoms related with SAPAP3 in Mouse Models of Alzheimer's Disease. (PubMed, Eur J Pharmacol) - "ZNS exerts neuroprotective effects in 5xFAD mice and improves AD-related cognitive impairment and AD-like lesions, which establishes ZNS as a promising therapeutic avenue for AD and its associated psychiatric symptoms."

Journal • Preclinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Psychiatry • Type 2 Diabetes Mellitus • APP • BDNF • DLG4 • GRIN2A

A novel SGCE splicing variant in a Chinese family with Myoclonus-Dystonia: Rare phenotype and phenotypic variability. (PubMed, Parkinsonism Relat Disord) - No abstract available

Journal • CNS Disorders • Dystonia • Movement Disorders • Pain

Infertility treatment in women with epilepsy: A systematic review. (PubMed, Epilepsy Behav) - "Available evidence suggests that ART is feasible in women with epilepsy, with most patients maintaining stable seizure control. Hormonal therapy may affect ASM pharmacokinetics and seizure threshold, thereby warranting close monitoring. Larger prospective studies are needed to better define ASM-specific effects and optimize care."

Journal • Review • CNS Disorders • Epilepsy • Gynecology • Infertility • Sexual Disorders

Challenges and opportunities for developing selective carbonic anhydrase inhibitors and activators for vertebrate isoforms. (PubMed, Enzymes) - "Carbonic anhydrase (CA, EC 4.2.1.1) inhibitors of the sulfonamide/sulfamate type, such as acetazolamide, thiazides/high-ceiling diuretics, methazolamide, ethoxzolamide, dichlorophenamide, dorzolamide, brinzolamide, antiepileptics (sulthiame, topiramate, zonisamide), or non-steroidal anti-inflammatory agents such as celecoxib and polmacoxib, are effective inhibitors of most CA isoforms present in vertebrates but their clinical use in various pathologies is associated with side effects. Significant efforts were done in the last decades for developing isoform-selective inhibitors for all 12 catalytically active mammalian isoforms, with important results being obtained by using the tail approach or by the discovery of new inhibitory chemotypes, such as the coumarins and their derivatives, the boron/selenium-containing compounds, etc. SLC-0111, an antitumor sulfonamide in clinical development is an example of a successful strategy emerged by using the tail approach, this..."

Journal • Review • CNS Disorders • Cognitive Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Oncology • Post-traumatic Stress Disorder • Psychiatry

Carbonic anhydrases I and II. (PubMed, Enzymes) - "Many CA inhibitors are in clinical use for the management of such conditions, among which are acetazolamide, thiazides and high-ceiling diuretics, methazolamide, ethoxzolamide, dichlorophenamide, dorzolamide, brinzolamide, and antiepileptics such as sulthiame, topiramate and zonisamide, whereas SLC-0111 is in clinical development as an antitumor agent. CA activators are not yet used clinically, but they might have pharmacological applications in the management of neurodegeneration, emotional memory disorders, obsessive-compulsive disorders, phobias, generalized anxiety, and post-traumatic stress. Finding novel modulators of activity for these enzymes may lead to innovative therapeutic applications and deepen our understanding of enzymes, their inhibitors, and their activators."

Journal • Review • Alzheimer's Disease • Cardiovascular • CNS Disorders • Cognitive Disorders • Epilepsy • Genetic Disorders • Glaucoma • Hypertension • Immunology • Inflammatory Arthritis • Mood Disorders • Neuralgia • Obesity • Obsessive-Compulsive Disorder • Obstructive Sleep Apnea • Oncology • Ophthalmology • Osteoporosis • Pain • Post-traumatic Stress Disorder • Psychiatry • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology • Sleep Disorder

Antiseizure medication dosing and monitoring in the intensive care unit: a practical narrative review. (PubMed, Intensive Care Med) - "The use of ASMs in the ICU require a distinct approach from outpatient settings. Severity of illness, organ dysfunction and replacement devices, and frequent drug-drug interactions warrant tailored agent selection, dosing, and monitoring."

Journal • Review • CNS Disorders • Critical care • Epilepsy

Neurologists' Views on the Management of Uncontrolled Epilepsy in Spain: A Preliminary Survey. (PubMed, Neurol Ther) - "There is a discrepancy between neurologists' treatment goals and their acceptance of persistent seizures in Spanish neurological practice. Several factors may be limiting the achievement of early seizure freedom, including short patient consultations and a lack of familiarity with new treatments, especially among epilepsy non-specialists. Addressing these barriers could improve outcomes for people with uncontrolled epilepsy."

Journal • CNS Disorders • Epilepsy

Pharmacovigilance analysis of severe cutaneous adverse reactions associated with antiseizure medications: a FAERS database study with time-to-onset evaluation. (PubMed, Front Pharmacol) - "Phenytoin, lamotrigine, carbamazepine, zonisamide, and phenobarbital showed relatively strong disproportionality signals, whereas levetiracetam and valproate exhibited comparatively weaker overall signals but were associated with multiple SCAR phenotypes. Most events occur early after treatment initiation, particularly within the first month, indicating an early period of reporting concentration after ASM initiation. These findings provide hypothesis-generating pharmacovigilance evidence regarding the reporting patterns and time-to-onset characteristics of ASM-associated SCARs and may help inform future risk evaluation and monitoring strategies."

Adverse events • Journal • CNS Disorders • Epilepsy • Steven-Johnson Syndrome

Disparities in cyclic vomiting syndrome burden and healthcare utilization, a TriNetX study (BSG 2026) - "Primary outcomes included all-cause hospitalization, all-cause mortality, complications of severe vomiting, diagnostic testing intensity, and prophylactic medication use (amitriptyline, nortriptyline, doxepin, aprepitant, topiramate, levetiracetam, zonisamide). Females receive more prophylactic therapy than males. These findings highlight inequities in disease burden and healthcare utilization in CVS and support the need for targeted strategies to improve equity in care."

HEOR • Rare Diseases

The Zonisamide and Reinforcement for Reducing Alcohol Use (ZARRA) Study (clinicaltrials.gov) - P2 | N=205 | Active, not recruiting | Sponsor: Washington State University | Trial completion date: Aug 2026 ➔ Aug 2027 | Trial primary completion date: Aug 2026 ➔ Aug 2027

Trial completion date • Trial primary completion date • Addiction (Opioid and Alcohol) • CNS Disorders • Psychiatry

The Zonisamide and Reinforcement for Reducing Alcohol Use (ZARRA) Study (clinicaltrials.gov) - P2 | N=205 | Active, not recruiting | Sponsor: Washington State University | Recruiting ➔ Active, not recruiting

Enrollment closed • Addiction (Opioid and Alcohol) • CNS Disorders • Psychiatry

Anti-seizure medications and DRESS in paediatric patients: A FAERS disproportionality and time-to-onset analysis. (PubMed, Br J Clin Pharmacol) - "Significant signals of DRESS associated with 13 ASMs were identified in paediatric populations. Notably, signals were detected for the first time for ethosuximide, perampanel, fosphenytoin and eslicarbazepine by disproportionality analysis. TTO analysis demonstrated wear-out or random failure-type patterns in the occurrence of ASM-associated DRESS."

Journal • CNS Disorders • Eosinophilia • Epilepsy • Pediatrics

Compound POMGNT1 Variants Associated with Muscle-Eye-Brain Disease: Necessity of Comprehensive Genetic Testing (EAN 2026) - "Electroencephalography confirmed refractory epileptic encephalopathy, which ultimately responded to a four-drug antiepileptic regimen (valproate sodium, brivaracetam, zonisamide, lacosamide). Combined genetic and histopathological results were consistent with Muscle-Eye-Brain disease (MEB), a dystroglycanopathy within the CMD spectrum. Over one-third of MEB patients have epilepsy, approximately 20% of which suffer from refractory seizures. This case illustrates how compound heterozygosity with residual POMGNT1 activity permits prolonged survival, while predisposing to severe adult-onset neurological complications, necessitating extensive genetic testing to resolve complex neuromuscular phenotypes."

Cataract • CNS Disorders • Developmental Disorders • Epilepsy • Genetic Disorders • Muscular Dystrophy • Myositis • Ocular Inflammation • Ophthalmology • Ventriculomegaly • LAMB2

Weight Changes in Children and Adolescents with Epilepsy and Overweight/Obesity Treated with Zonisamide. (PubMed, Child Obes) - "BMI reduction persisted up to 2 years following zonisamide initiation in children with epilepsy. Further prospective studies are needed to evaluate the weight loss effect and safety of zonisamide in children with epilepsy and elevated BMI."

Journal • CNS Disorders • Epilepsy • Genetic Disorders • Obesity

Prediction of Zonisamide Concentration in Pediatric Patients With Epilepsy: A Machine Learning Approach. (PubMed, CNS Neurosci Ther) - "This study successfully constructed and validated a ZNS concentration prediction model for pediatric patients with epilepsy based on the random forest algorithm. The model demonstrated high precision, strong stability, and good generalization ability. Gender, dose, uric acid, and total protein are core variables influencing ZNS concentration. The findings can provide a reference for the formulation of individualized ZNS dosing regimens in children."

Journal • Retrospective data • CNS Disorders • Epilepsy • Pediatrics