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Re: Medication help please! » JennyR9306

Posted by azalea on October 18, 2008, at 14:23:52

In reply to Re: Medication help please!, posted by JennyR9306 on October 18, 2008, at 9:07:49

Zonegran (zonisamide) is an anticonvulsant with mood stabilizing properties. It is not FDA-approved for bipolar disorder, but shows promise in research. It typically causes weight loss, in contrast to many other meds for bipolar.

J Affect Disord. 2008 Jan;105(1-3):311-4. Epub 2007 Jun 21.

Is adjunctive open-label zonisamide effective for bipolar disorder?

Ghaemi SN, Shirzadi AA, Klugman J, Berv DA, Pardo TB, Filkowski MM.
Bipolar Disorder Research Program, Department of Psychiatry, Emory University, Atlanta, GA 30322, United States. nghaemi@emory.edu

OBJECTIVE: To assess the effectiveness and safety of zonisamide in bipolar disorder. METHODS: A chart review was conducted of naturalistic treatment with zonisamide in 35 outpatients meeting DSM-IV criteria for bipolar disorder (9 males, 26 females; mean +/- SD age = 29.2 +/- 12.7; 14 with bipolar disorder type I, 6 with bipolar disorder type II, and 14 with bipolar disorder not otherwise specified). Patients received zonisamide adjunctive therapy between January 1994 and December 2004. Treatment response was defined as a Clinical Global Impressions - Improvement (CGI-I) scale score of +2 (much improved) or + 3 (very much improved). RESULTS: Zonisamide was moderately to markedly effective in 9 subjects (26%). Indication for treatment included depressive (34.3%, [12/35]), manic/hypomanic (28.6%, [10/35]), or mixed (31.4%, [11/35]) symptoms. The mean zonisamide dose was 130 mg/d for a mean duration of treatment of 27.0 +/- 32.3 weeks. Sedation (25%, [4/16]) was the most common side effect; 19/35 (54.3%) reported no side effects. 17/35 (49%) patients terminated early, mostly due to adverse effects (6/35). Using a multivariable model, predictors of response, concurrent mood stabilizers, dose and bipolar subtype (bipolar type I > type II/NOS), were controlled for in this sample. CONCLUSIONS: In 35 persons with bipolar disorder taking standard mood stabilizers and other psychotropic agents, adjunctive zonisamide appears to have modest benefit in global improvement when added to a pre-existing complex medication regimen in patients with bipolar spectrum disorder. These pilot data support the need for larger studies to test the potential efficacy of zonisamide for treatment in mood disorders.

> My pdoc will not put me on an AD because of the potential for mania. Does anyone know anything about zonegran?


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poster:azalea thread:857927
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