Efficacy, tolerability, and retention rates of zonisamide in older adult patients with focal-onset epilepsy: Experiences from two tertiary epilepsy centers

The objective of this study was to evaluate the efficacy, tolerability, and retention rates for zonisamide (ZNS) in older adult patients with focal-onset epilepsy. Chart reviews of patients aged 60years and older with focal-onset epilepsy treated with ZNS in two tertiary epilepsy centers were analyz...

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Veröffentlicht in:Epilepsy & behavior 2017-11, Vol.76, p.19-23
Hauptverfasser: Doğan, Ebru Apaydın, Genç, Emine, Genç, Bülent Oğuz, Erdoğan, Çağla
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Sprache:eng
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Zusammenfassung:The objective of this study was to evaluate the efficacy, tolerability, and retention rates for zonisamide (ZNS) in older adult patients with focal-onset epilepsy. Chart reviews of patients aged 60years and older with focal-onset epilepsy treated with ZNS in two tertiary epilepsy centers were analyzed retrospectively. Eighty-five patients (41 males, 44 females) aged over 60years (range: 60–81) with focal-onset epilepsy treated with ZNS were identified; 55.3% of the patients (n=47) were on monotherapy. The median and average doses of ZNS doses were 200mg/day (range: 100–400) and 212.9±84.2mg/day, respectively. With ZNS treatment, 67.1% of the patients (n=57) were seizure-free for a median of 28months (range: 10–56) whereas 20% (n=17) of the patients had seizures that were unresponsive to ZNS treatment. Best seizure control was achieved in patients with poststroke epilepsy; seizure freedom was 80% in this subgroup. Overall retention rate was found to be 83.5%. There was no significant relation between receiving poly- or monotherapy and discontinuation of ZNS (p=0.18). Thirty-two of the patients (37.6%) lost weight. Median weight loss was 8kg (range: 2–16). There was no significant correlation between weight loss and the administered doses of ZNS (r=0.34; p=0.12). Despite limitations due to the retrospective design of the study, the results show that ZNS is a well-retained drug with high efficacy in older adult patients with epilepsy. •Epilepsy is the third most common neurologic disease following dementia and stroke in older adults.•Recurrence of seizures is more frequent and mortality is higher in older adults.•Treatment of older epilepsy patients is very important since this group is forming an increasing part of the population.•Age-related physiological changes and co-morbirdities should always be taken into account.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2017.08.040