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Zonisamide for Bipolar Disorder

Zonisamide is an antiseizure medication that is prescribed off-label for treatment of bipolar disorder. It is not recommended for individuals under age 16.

  1. Dosing & Administration

    • Zonisamide is taken orally and is available in 25mg, 50mg and 100mg capsules. It is taken either once or twice daily.

    Function

    • The exact mechanism of zonisamide in the treatment of bipolar disorder is not known. However, zonisamide acts by blocking sodium channels and reducing inward currents of calcium ions, which appears to produce a mood stabilizing effect.

    Contraindications

    • Zonisamide may cause fetal abnormalities, so use of zonisamide is not advised during pregnancy. Individuals with poor kidney or liver functioning require close monitoring when taking zonisamide in order to ensure the drug does not build up to toxic levels in the bloodstream.

    Side Effects

    • Common side effects include drowsiness, loss of appetite, dizziness, impaired coordination, headache, nausea, agitation and irritability. More serious side effects include worsening of seizures, kidney stones, changes in mood, dissociation and psychosis.

    Warning

    • If a skin rash, fever or significant decrease in sweating results after taking zonisamide, discontinue use and contact your medical provider immediately.

    Withdrawal

    • Abrupt cessation of zonisamide after long-term use may result in withdrawal symptoms, including seizures. The dosage of zonisamide should be gradually decreased before discontinuation after long-term use.

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