Abstract
We administered zonisamide (ZNS) to patients with West syndrome in different titration
protocols and compared their short-term therapeutic effects. We designed three protocols
to raise the serum ZNS concentration (SZC): (1) increase the dose in three steps,
from 3 to 10 mg/kg every 3 days, (2) increase the dose from 5 to 10 mg/kg over 3–7 days, and (3) start with 10 mg/kg and maintain this dosage for 2 weeks. The subjects were 23 infants with West
syndrome, 8 of whom comprised the 1st group, 5 the 2nd group, and the remaining 10,
the 3rd group. As a result, excellent and good effects were obtained in a total of
seven patients (30.4%) and one patient, respectively (1/8 in the 1st step-up group,
3/5 in the 2nd step-up group, and 4/10 in the 3rd group). The maximum SZC was higher
in the excellent and good effect groups (n=8; 32.0±8.0 μg/ml) than in the ineffective group (n=15; 22.4±8.2 μg/ml) (P<0.05). The period of time required for cessation of spasms appeared shorter in the
3rd group (n=4; mean=5.7 days) than in the 1st and 2nd groups (n=4; mean=10.3 days). There were few side effects except for transient hyperthermia
and gastrointestinal symptoms. Our new protocol of starting with 10 mg/kg of ZNS can be introduced safely and make a therapeutic judgment feasible within
2 weeks.
Keywords
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Article info
Publication history
Accepted:
August 23,
2004
Received in revised form:
July 22,
2004
Received:
May 18,
2004
Identification
Copyright
© 2004 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
