zonisamide / Generic mfg. - LARVOL DELTA

Study of the Pharmacokinetics, Safety, and Tolerability of ZONISADE in Children 1 Month to 17 Years of Age With Partial-onset Seizures (clinicaltrials.gov) - P4 | N=40 | Not yet recruiting | Sponsor: Azurity Pharmaceuticals | Trial completion date: Sep 2026 ➔ Sep 2027 | Trial primary completion date: Sep 2026 ➔ Sep 2027

Trial completion date • Trial primary completion date • CNS Disorders • Epilepsy

FROM MISDIAGNOSED SEIZURES TO SUDDEN CARDIAC ARREST: UNMASKING PEDIATRIC CPVT (ACC 2026) - "She was treated by neurology with escalating doses of Levetiracetam, Oxcarbazepine, Zonisamide and rescue therapy with Intranasal Diazepam with no success...The addition of flecainide was considered but deferred since she had no recurrent syncope or ICD therapies. Early recognition of CPVT and timely initiation of medical therapy are critical to prevent recurrent ventricular tachyarrhythmias. Prompt diagnosis and treatment reduce the risk of sudden cardiac arrest and may even obviate the need for ICD implantation."

Clinical • Asthma • Cardiovascular • CNS Disorders • Epilepsy • Heart Failure • Immunology • Pediatrics • Respiratory Diseases • Ventricular Tachycardia

Progressive Myoclonic Epilepsies - A Pragmatic Review. (PubMed, Neurol India) - "This review explores the clinical features and genetic factors associated with the more prevalent as well as recently described forms of PME for effective clinical evaluation, and suggests management strategies for this challenging condition."

Journal • Review • Alzheimer's Disease • Ataxia • CNS Disorders • Cognitive Disorders • Epilepsy • Metabolic Disorders • Movement Disorders

Prenatal antiseizure drug exposure and risk of neurodevelopmental disorders in children: population based cohort study. (PubMed, BMJ) - "The findings strengthen the evidence for increased neurodevelopmental risks among children with prenatal valproate exposure and suggest the need for further evaluation of zonisamide. Signals for other antiseizure drugs, observed in the context of several comparisons and rare outcomes, require confirmation as data accumulate."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Autism Spectrum Disorder • Behavior Disorders • CNS Disorders • Cognitive Disorders • Developmental Disorders • Epilepsy • Genetic Disorders • Mental Retardation • Psychiatry

Refractory Partial Status Epilepticus in the Setting of Anti-GAD65 Autoimmune Encephalitis in an 18-Year-Old Female with an MRI Contraindication: A Case Report (AAN 2026) - "The patient had stopped Keppra due to side effects. She was then started on zonisamide...Acyclovir and fosphenytoin were initially started, with EEG continuing to show seizures...She was treated with multiple anti-epileptic drugs, IVIG, and later rituximab...She was discharged on fycompa, vimpat, and a prednisone taper with outpatient follow-up. This case highlights the importance of early diagnosis of anti-GAD65 autoimmune encephalitis in young patients with new-onset seizures, even without MRI. Prompt treatment, including PLEX, can prevent progression to status epilepticus and support recovery."

Case report • Clinical • CNS Disorders • Epilepsy • Immunology

SCN9A mutations may contribute to medically refractory epilepsy (AAN 2026) - "His seizures were refractory to brivaracetam, lacosamide, zonisamide, oxcarbazepine. He is currently on clobazam, felbamate and valproic acid, with seizures occurring every other week...He is currently on zonisamide, levetiracetam, rufinamide, cannabidiol, and clobazam and continues to have seizures every few days... These cases demonstrate SCN9A gene mutations in patients with refractory epilepsy, suggesting a possible link. These specific gene mutations have not been well characterized in literature; thus, these cases may provide insight into mutations that may be pathogenic. Further research is necessary to determine exactly what role these variants play in epilepsy."

CNS Disorders • Epilepsy • NAV1 • SCN8A

Immune Checkpoint Inhibitor Induced Parkinsonism and Breakthrough Seizures in Medically Refractory Epilepsy: A Case Report (AAN 2026) - "Previously, multiple alternative antiseizure medications including Carbamazepine, Gabapentin, Ethosuximide, Zonisamide, and Levetiracetam were ineffective or poorly tolerated.The patient had received two cycles of Cemiplimab (March–April 2025) for SCC, after which his tremors and rigidity progressively worsened. This case underscores that seizures and subacute parkinsonism are rare, but significant ICI related complications. Symptom stabilization was achieved with a combination of Lacosamide, Lamotrigine, Clobazam, and Corticosteroids after other antiepileptics were poorly tolerated."

Case report • Checkpoint inhibition • Clinical • CNS Disorders • Epilepsy • Immunology • Movement Disorders • Non-melanoma Skin Cancer • Oncology • Parkinson's Disease • Squamous Cell Carcinoma • Squamous Cell Skin Cancer

Infertility therapy in seizure disorders: systematic review of literature (AAN 2026) - "The patients were treated with 0-2 ASMs, including carbamazepine, lamotrigine, levetiracetam, oxcarbazepine, valproate, and zonisamide. Many patients tolerated ART without worsening seizures. Concomitant usage of ASMs and ART may affect reproductive outcomes. Despite the systematic approach, our search yielded a limited number of reports, underscoring the need for further investigation."

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

Consensus Molecules Associated with Parkinson's Disease. (PubMed, Neurol Int) - "Drugs include L-dopa (49%), carbidopa (63%), benserazide (50%), entacapone (74%), tolcapone (56%), rasagiline (76%), selegiline (46%), pargyline (4%), ropinirole (61%), pramipexole (56%), lisuride (27%), cabergoline (16%), bromocriptine (12%), and zonisamide (9%). Adjunctive therapies include droxidopa (33%), trihexyphenidyl (28%), biperiden (17%), amantadine (24%), memantine (7%), rivastigmine (13%), donepezil (6%), galantamine (4%), domperidone (6%), clonazepam (4%), tetrabenazine (16%), mazindol (13%), quetiapine (6%), and clozapine (4%). Contraindicated drugs include haloperidol (4%), sulpiride (3%), and methyldopa (6%)...Chemical inducers of PD include 6-hydroxydopamine (40%), N-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 78%), tetrahydropyridine (77%), probenecid (4%), quinolinic acid (4%), 1,2,3,4-tetrahydroisoquinoline (TIQ, 16%), salsolinol (32%), rotenone (25%), and β-Methylamino-L-alanine (BMAA, 29%). Notably, our study highlights conditional essential..."

Journal • Review • CNS Disorders • Movement Disorders • Parkinson's Disease

Efficacy of monotherapy with zonisamide and proposed reference interval in dogs with epilepsy: a cohort of 207 dogs (2011-2021). (PubMed, J Vet Intern Med) - "This study demonstrated that ZNS monotherapy is effective for treatment of non-structural epilepsy. The proposed RI, 10-55 μg/mL, is a broader range than that in human medicine, 10-40 μg/mL."

Journal • Monotherapy • CNS Disorders • Epilepsy

Retrospective study on canine idiopathic epilepsy treatment in primary care practices in the United States. (PubMed, Front Vet Sci) - "Phenobarbital (34.9%) and levetiracetam (31.3%) were the most prescribed first-line-ASDs, followed by zonisamide (22.9%) and potassium bromide (11.1%)...Extended-release levetiracetam was used in 97.4% of cases; the median dose was 29.7 mg/kg (IQR 24.1-34.6 mg/kg) PO, prescribed every 12 h in 87.7% of dogs...Prescribing practices generally aligned with the ACVIM guidelines, suggesting good implementation of this knowledge in one of the largest US primary care providers. The variability in levetiracetam and potassium bromide dosing highlights the need for updated evidence-based dosing guidelines, while education on the value of therapeutic drug monitoring could support veterinary and pet-owner's decision making in the management of IE."

Journal • Retrospective data • CNS Disorders • Epilepsy

Complex Visual Hallucinations in Post-stroke Epilepsy: A Case Report and Literature Review. (PubMed, Intern Med) - "The symptoms resolved with levetiracetam and were maintained with zonisamide. In conclusion, CVH may reflect visual memory and retention and can be accompanied by psychiatric symptoms. Improved recognition of CVH as a manifestation of PSE may help avoid misdiagnoses and lead to appropriate treatment."

Journal • Review • Cardiovascular • CNS Disorders • Epilepsy • Psychiatry

Evaluation of bone safety and antiseizure medications: a multi-source pharmacovigilance and Mendelian randomization analysis. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "Significant associations of bone health were identified for traditional enzyme-inducing ASMs, including carbamazepine, phenytoin, and phenobarbital, and newer agents, including perampanel, brivaracetam, lacosamide, and zonisamide. By integrating real-world pharmacovigilance with genetic insights, this study characterizes the associations between both conventional and newer ASMs and adverse bone health outcomes, mechanistically implicating the role of Calcium and MAPK signaling pathways. Furthermore, we identified several key regulatory genes."

Adverse events • Journal • CNS Disorders • Epilepsy • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Rheumatology • MFN2 • PLOD1 • TNFRSF9

Clinical reliability and concordance of drug-drug interaction tools as clinical decision support systems in patients with epilepsy. (PubMed, Seizure) - "When using DDITs as CDSS, it is important to consider that the results of different tools may vary greatly from one another and do not necessarily correlate with clinical AEs."

Journal • CNS Disorders • Epilepsy

The Effects of Combination Zonisamide and Bupropion on Switching to an Electronic Cigarette (clinicaltrials.gov) - P3 | N=180 | Completed | Sponsor: Rose Research Center, LLC | Active, not recruiting ➔ Completed

Trial completion • Tobacco Cessation

Infantile Epsilon-Sarcoglycan (SGCE) Myoclonus-Dystonia: Diagnostic Pitfalls and Poor Response to Pharmacologic Treatment. (PubMed, Cureus) - "Trials with zonisamide, carbamazepine, sodium valproate, and clonazepam were ineffective; however, motor and cognitive development remained within the average range. Genetic testing was essential for diagnosis, pharmacologic response was limited, and functional outcome remained favorable. The later emergence of behavioral symptoms underscores the need for long-term multidisciplinary follow-up."

Journal • CNS Disorders • Dystonia • Epilepsy • Mental Retardation • Movement Disorders • Psychiatry

Two Cases of Psychiatric Symptoms Associated with Zonisamide Antiepileptic Treatment. (PubMed, Clin Psychopharmacol Neurosci) - "In Case 2, despite escalating antipsychotic medications (risperidone, clozapine), psychotic symptoms persisted, likely due to ongoing zonisamide use. Clinicians should monitor for mental health changes during zonisamide treatment and consider drug discontinuation or substitution with alternative antiepileptics (e.g., sodium valproate) if psychiatric adverse effects emerge. Awareness of this association is crucial to avoid misdiagnosis and optimize epilepsy management."

Journal • CNS Disorders • Epilepsy • Insomnia • Psychiatry • Sleep Disorder

Update on Medical Treatments for Essential Tremor: An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review. (PubMed, Mov Disord) - "Current evidence from RCTs with at least 1 month of follow-up is insufficient to confidently support the efficacy of available medical treatments for ET. There is a need for longer, higher-quality clinical trials to improve treatment recommendations and guide decision-making for clinicians and patients with ET."

Journal • Review • CNS Disorders • Essential Tremor • Movement Disorders • Parkinson's Disease

Exploring the Antiamoebic Potential of Zonisamide and Perampanel against Naegleria fowleri: Insights from In Vitro and Docking Studies. (PubMed, ACS Omega) - "These findings support their candidacy for further development as PAM therapeutics. Beyond the scientific results, the approach aligns with Sustainable Development Goal 3 (Good Health and Well-being) by promoting innovative, accessible treatment strategies for neglected diseases and with SDG 9 (industry, innovation, and infrastructure) through the use of computational drug repurposing technologies."

Journal • Preclinical • CTSB

The persisting puzzle of OFF time in advanced Parkinson's disease. (PubMed, Brain) - "The complexity of managing motor fluctuations is further highlighted by the effectiveness of various non-dopaminergic adjunctive therapies for reducing OFF time in levodopa-treated patients, as shown by placebo-controlled clinical trials with adjunctive istradefylline, amantadine, zonisamide, and deep brain stimulation. For achieving better control of OFF time in advanced Parkinson's disease, there is a need for discovering therapeutic strategies acting beyond the limits of today's dopaminergic therapies. Modeling brain circuitry with tools like deterministic neural-computational analysis may provide valuable pharmacological and electrophysiological insights for better understanding of motor fluctuations and the choice of appropriate therapeutic targets."

Clinical • Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Bayesian-Based Pharmacokinetic Framework Integrated with Therapeutic Drug Monitoring for Assessing Adherence to Antiseizure Medications: A Clinical Trial Simulation Study. (PubMed, J Med Internet Res) - "This study proposed an innovative Bayesian-based pharmacokinetic (PK) framework integrated with TDM data to address the above limitations, with a focus on 14 widely prescribed ASMs, including brivaracetam, carbamazepine, clobazam, eslicarbazepine acetate, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, phenobarbital, topiramate, valproic acid, vigabatrin, and zonisamide. This study establishes a Bayesian-based PK approach to enhance the assessment of ASMs adherence. This approach facilitates a paradigm shift from population-based management to patient-specific adherence profiling, offering a practical methodology for the precise evaluation of medication-taking behaviors."

Journal • PK/PD data • CNS Disorders • Epilepsy

Zonisamide-induced pleural effusion and agranulocytosis: a case report of a rare adverse reaction. (PubMed, Neurol Sci) - "All abnormalities resolved completely within ten days after discontinuation of zonisamide. To our knowledge, such a combination of agranulocytosis and pleural effusion associated with zonisamide has not been previously reported, and this rare adverse event warrants clinical attention."

Journal • Pleural effusion • Agranulocytosis • CNS Disorders • Granulocytopenia • Hematological Disorders • Movement Disorders • Neutropenia • Parkinson's Disease • Pulmonary Disease • Respiratory Diseases • Thrombocytopenia

Retraction notice to "Optimal rainwater harvesting locations for arid and semi-arid regions by using MCDM-based GIS techniques" [Heliyon 11 (2025) e42090]. (PubMed, Heliyon) - "[This retracts the article DOI: 10.1016/j.heliyon.2025.e42090.]."

Journal

Application of acoustic ejection mass spectrometry for plasma protein binding assay using flux dialysis. (PubMed, Drug Metab Dispos) - "Herein, we validated this approach using 10 commercially available compounds with known fu values-imipramine, indomethacin, itraconazole, lapatinib, nicardipine, warfarin, chlorpromazine, rivastigmine, zonisamide, and ritonavir-with a wide fu range covering from very high binding (fu ≤ 0.01) to low binding (fu > 0.10) in human plasma. SIGNIFICANCE STATEMENT: This study bridges the gap between flux dialysis and acoustic ejection mass spectrometry by creating a synergistic analytical framework for plasma protein binding assays, addressing limitations of both methods and enabling high-throughput applications with improved accuracy and efficiency. The combination of flux dialysis and acoustic ejection mass spectrometry will make a positive contribution to the development of high-throughput in vitro absorption, distribution, metabolism and excretion assays in drug discovery."

Journal

Phase II pilot randomized trial of zonisamide for disease modification in prodromal Lewy body disease. (PubMed, NPJ Parkinsons Dis) - "Somnolence, fatigue, decreased appetite, and constipation were frequent adverse events. Although findings are inconclusive due to limited power, this study provides valuable methodological insights for preventive LBD trials."

Clinical • Journal • P2 data • CNS Disorders • Cognitive Disorders • Constipation • Dementia • Fatigue • Gastroenterology • Gastrointestinal Disorder • Lewy Body Disease • Movement Disorders