Zonisamide

What is zonisamide?

Zonisamide is used together with other medicines to treat partial seizures in adults and teenagers at least 16 years old.

Zonisamide may also be used for purposes not listed in this medication guide.

Important Information

Taking zonisamide can cause permanent vision loss. Tell your doctor right away if you have any eye pain or redness or any changes in your vision.

Some people have thoughts about suicide while taking zonisamide. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before taking this medicine

You should not use zonisamide if you are allergic to it.

You may not be able to take zonisamide if you have ever had a severe allergic to a sulfa drug.

Tell your doctor if you have ever had:

  • liver disease;
  • kidney disease;
  • high levels of ammonia;
  • stomach flu or illness causing diarrhea;
  • a growth disorder;
  • a bone disorder that causes soft or weak bones or low bone mineral density;
  • depression, or suicidal thoughts or actions;
  • if you have ever had metabolic acidosis (too much acid in your blood); or
  • if you have been on a ketogenic diet (high-fat, high-protein, low-carb).

Some people have thoughts about suicide while taking zonisamide. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Zonisamide may harm an unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of zonisamide on the baby.

You should not breastfeed while using zonisamide.

Zonisamide is not approved for use by anyone younger than 16 years old.

How should I take zonisamide?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Zonisamide can be taken with or without food.

Swallow the capsule whole and do not crush, chew, break, or open it.

While using zonisamide, you may need frequent blood tests.

Do not stop using zonisamide suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

Do not share zonisamide with another person, even if they have the same symptoms you have.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention

Overdose symptoms may include slow heart rate, feeling light-headed, fainting, and slow or shallow breathing.

What should I avoid while taking zonisamide?

Avoid driving or hazardous activity until you know how zonisamide will affect you. Your reactions could be impaired.

Drinking alcohol with this medicine can cause side effects.

Zonisamide side effects

Get emergency medical help if you have signs of an allergic reaction: any form of skin rashhives; fever, swollen glands, feeling weak or tired, severe muscle pain, unusual bruising or bleeding; yellowing of your skin or eyes; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, anxietypanic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • eye pain or redness or any changes in your vision;
  • decreased sweating, feeling very hot;
  • signs of metabolic acidosis–confusion, vomiting, lack of energy, irregular heartbeats;
  • symptoms of a blood cell disorder–fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • symptoms of a kidney stone–severe pain in your stomach or lower back, blood in your urine;
  • increased or worsening seizures;
  • the first sign of any skin rash, no matter how mild; or
  • severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • drowsiness, dizziness;
  • problems with memory or concentration;
  • feeling agitated or irritable;
  • loss of coordination, trouble walking; or
  • loss of appetite.

Zonisamide dosing information

Usual Adult Dose for Seizures:

16 years of age and older:
-Initial dose: 100 mg orally once a day
-Titration: After 2 weeks at 100 mg/day, the dose may be increased to 200 mg/day as either a single or divided dose (100 mg orally 2 times a day) for at least 2 weeks; it can then be increased to 300 mg/day, then 400 mg/day either as a single daily dose or divided into 2 daily doses, with the dose stable for at least 2 weeks to achieve steady state at each level
-Maintenance dose: 400 mg/day
-Maximum dose: 600 mg/day

Comments:
-This drug may be taken with or without food.
-Capsules should be swallowed whole.
-Because of the long half-life of this drug, up to 2 weeks may be required to achieve steady state levels upon reaching a stable dose or following dosage adjustment.
-The prescriber may wish to prolong the duration of treatment at the lower doses in order to fully assess the effects of this drug at steady state (noting that many of the side effects are more frequent at doses of 300 mg per day and above). Although there is some evidence of greater response at doses above 100 to 200 mg/day, the increase appears small and formal dose response studies have not been conducted.

Use: As adjunctive therapy in the treatment of partial seizures

Usual Pediatric Dose for Seizures:

Less than 16 years of age: Not recommended
16 years of age and older: See adult dosing

What other drugs will affect zonisamide?

Taking zonisamide with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking zonisamide with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety or depression.

Other drugs may interact with zonisamide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Epilepsy – Complex Partial Seizures

Overview

A complex partial seizure is also known as a focal impaired awareness seizure or a focal onset impaired awareness seizure. This type of seizure starts in a single area of the brain. This area is usually, but not always, the temporal lobe of the brain.

While it’s most common in people with epilepsy, this type of seizure has been known to occur in people with cerebral palsy. It includes uncontrolled movement of limbs or other body parts. These seizures are usually very short, and the person having the seizure will be unaware of their surroundings. They may also become unconscious for a brief period of time.

Complex partial seizures and epilepsy

For those with epilepsy, this is the most common type of seizure. But while complex partial seizures are often related to epilepsy, this is not the only reason for someone to have seizures.

Symptoms of complex partial seizures

A complex partial seizure can have multiple possible symptoms. However, these symptoms may occur during one seizure and not another. Complex partial seizures normally only last a few minutes. Seizures beginning in the frontal lobe area of the brain are usually shorter than those that start in the temporal lobe area.

Symptoms will often start abruptly, and the person experiencing the seizure may not know they have had one. The person may:

  • stare blankly or look like they’re daydreaming
  • be unable to respond
  • wake from sleep suddenly
  • swallow, smack their lips, or otherwise move their mouth repetitively
  • pick at things like the air, clothing, or furniture
  • say words repetitively
  • scream, laugh, or cry
  • perform actions that can cause potential danger to themselves, like walking in front of moving cars or removing all or portions of their clothing
  • perform movements like they are riding a bicycle
  • be unaware, either partially or totally, of their surroundings
  • hallucinate
  • try to hurt themselves
  • experience confusion when the seizure ends
  • be unable to remember the seizure when it’s over

Causes of complex partial seizures

While epilepsy is one of the most common causes, there are other conditions that can cause a complex partial seizure. Some of these conditions are:

  • psychological distress or trauma
  • neurologic conditions
  • extreme stress
  • anxiety and depression
  • autism
  • other medical conditions related to the brain
  • damage caused prior to birth
  • neurofibromatosis

Common triggers

A complex partial seizure can happen anytime and usually without much warning. They can even occur when the person is in the middle of an activity. Sometimes the person will have an aura right before having a complex partial seizure. An aura is also called a simple partial seizure. It can act as a warning signal that a bigger seizure is coming.

There are some additional factors that can trigger a seizure, including:

  • flashing lights
  • low blood sugar
  • high fever
  • reactions to some medications

Diagnosing a complex partial seizure

Before deciding on treatment, a doctor will need to confirm that a person is having complex partial seizures. The doctor will need as many details as possible from the person having the seizures as well as from someone who has seen these episodes on a number of occasions. The doctor will need to know what happens before, during, and after each episode.

If a doctor suspects a complex partial seizure, they will usually order a diagnostic test to confirm. An electroencephalogram (EEG) may be done initially. However, the EEG will usually need to record a seizure to be accurate. Other tests that may be given to look for any potential cause of the seizures are a CT scan and an MRI. A blood test and neurological exam may be done as well. These may help the doctor find a cause (if there is a recognizable cause) without seeing an actual seizure while testing.

How are they treated and managed?

There are various types of treatment for complex partial seizures once the condition has been diagnosed. The following are some of the possible treatment options:

The type of treatment used is determined by the cause of the seizures, other medical conditions, and other factors.

Associated health conditions

A complex partial seizure can happen to anyone. However, there are some medical conditions that are more prone to these types of seizures. These medical conditions include:

  • epilepsy (most common)
  • cerebral palsy
  • infection in the brain
  • brain injury
  • tumor in the brain
  • stroke
  • some heart conditions

Sometimes a complex partial seizure will happen to someone without any known medical conditions. There is not always a cause that can be determined in some cases of complex partial seizures.

Outlook

Once diagnosed, seizures — including complex partial seizures — can be managed through a variety of treatment options. In some cases, children will outgrow the seizures.

If you think that you or someone you know is having seizures, it’s important to talk to a doctor for proper diagnosis and treatment.

You should contact a medical professional immediately if someone you know is having a seizure and any of the following is true:

  • this is the person’s first seizure
  • the seizure lasts more than five minutes
  • the person has a high fever
  • the person does not become conscious after the seizure is over
  • the person has diabetes
  • the person is or might be pregnant

Complex Partial Seizures

Overview

A complex partial seizure is also known as a focal impaired awareness seizure or a focal onset impaired awareness seizure. This type of seizure starts in a single area of the brain. This area is usually, but not always, the temporal lobe of the brain.

While it’s most common in people with epilepsy, this type of seizure has been known to occur in people with cerebral palsy. It includes uncontrolled movement of limbs or other body parts. These seizures are usually very short, and the person having the seizure will be unaware of their surroundings. They may also become unconscious for a brief period of time.

Complex partial seizures and epilepsy

For those with epilepsy, this is the most common type of seizure. But while complex partial seizures are often related to epilepsy, this is not the only reason for someone to have seizures.

Symptoms of complex partial seizures

A complex partial seizure can have multiple possible symptoms. However, these symptoms may occur during one seizure and not another. Complex partial seizures normally only last a few minutes. Seizures beginning in the frontal lobe area of the brain are usually shorter than those that start in the temporal lobe area.

Symptoms will often start abruptly, and the person experiencing the seizure may not know they have had one. The person may:

  • stare blankly or look like they’re daydreaming
  • be unable to respond
  • wake from sleep suddenly
  • swallow, smack their lips, or otherwise move their mouth repetitively
  • pick at things like the air, clothing, or furniture
  • say words repetitively
  • scream, laugh, or cry
  • perform actions that can cause potential danger to themselves, like walking in front of moving cars or removing all or portions of their clothing
  • perform movements like they are riding a bicycle
  • be unaware, either partially or totally, of their surroundings
  • hallucinate
  • try to hurt themselves
  • experience confusion when the seizure ends
  • be unable to remember the seizure when it’s over

Causes of complex partial seizures

While epilepsy is one of the most common causes, there are other conditions that can cause a complex partial seizure. Some of these conditions are:

  • psychological distress or trauma
  • neurologic conditions
  • extreme stress
  • anxiety and depression
  • autism
  • other medical conditions related to the brain
  • damage caused prior to birth
  • neurofibromatosis

Common triggers

A complex partial seizure can happen anytime and usually without much warning. They can even occur when the person is in the middle of an activity. Sometimes the person will have an aura right before having a complex partial seizure. An aura is also called a simple partial seizure. It can act as a warning signal that a bigger seizure is coming.

There are some additional factors that can trigger a seizure, including:

  • flashing lights
  • low blood sugar
  • high fever
  • reactions to some medications

Diagnosing a complex partial seizure

Before deciding on treatment, a doctor will need to confirm that a person is having complex partial seizures. The doctor will need as many details as possible from the person having the seizures as well as from someone who has seen these episodes on a number of occasions. The doctor will need to know what happens before, during, and after each episode.

If a doctor suspects a complex partial seizure, they will usually order a diagnostic test to confirm. An electroencephalogram (EEG) may be done initially. However, the EEG will usually need to record a seizure to be accurate. Other tests that may be given to look for any potential cause of the seizures are a CT scan and an MRI. A blood test and neurological exam may be done as well. These may help the doctor find a cause (if there is a recognizable cause) without seeing an actual seizure while testing.

How are they treated and managed?

There are various types of treatment for complex partial seizures once the condition has been diagnosed. The following are some of the possible treatment options:

The type of treatment used is determined by the cause of the seizures, other medical conditions, and other factors.

Associated health conditions

A complex partial seizure can happen to anyone. However, there are some medical conditions that are more prone to these types of seizures. These medical conditions include:

  • epilepsy (most common)
  • cerebral palsy
  • infection in the brain
  • brain injury
  • tumor in the brain
  • stroke
  • some heart conditions

Sometimes a complex partial seizure will happen to someone without any known medical conditions. There is not always a cause that can be determined in some cases of complex partial seizures.

Outlook

Once diagnosed, seizures — including complex partial seizures — can be managed through a variety of treatment options. In some cases, children will outgrow the seizures.

If you think that you or someone you know is having seizures, it’s important to talk to a doctor for proper diagnosis and treatment.

You should contact a medical professional immediately if someone you know is having a seizure and any of the following is true:

  • this is the person’s first seizure
  • the seizure lasts more than five minutes
  • the person has a high fever
  • the person does not become conscious after the seizure is over
  • the person has diabetes
  • the person is or might be pregnant

Last medically reviewed on June 1, 2017

Epileptic Seizures 1

You will find it won’t be very often I do post like this as I don’t suffer seizures on a daily basis.

Yesterday 14 June 2020 I suffered two seizures one Simple and one Complex. Fortunately they didn’t occur literally one after the other, which can sometimes be the case if i take two in a day.

The seizures (or turns as I refer to them as) were approximately ten hours apart.

The strange thing for me I suppose was I was unusually quiet for a while after the Simple Partial, where as it’s normally the other way around I usually go quiet after a Complex Partial seizure