Zonegran (Zonisamide, Elan) is an anticonvulsant agent that has significant efficacy for the management of headache.  We have had experience with about 50 patients with intractable headaches who have failed all other regimens including other anti-convulsants.

Dose: 100 mg at night for two weeks, then 200 mg at bedtime thereafter. One  may raise to 300 mg/day after a few weeks.  Most patients who have noted benefit report improvement at the 200 mg dose.

Side Effects: Cognitive dysfunction similar but less frequently than with Topamax. We have had some patient report hair loss.

Therefore this agent has low adverse event profile and significant efficacy.  While not as strong an inducer of weight loss as Topamax, patients often loose weight on Zonegran and have essentially no side effects.  More here as experience builds.

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