Commentary on Miura
نویسنده
چکیده
Dr. Miura’s study evaluated the use of zonisamide in children with cryptogenic localization-related epilepsy, as monotherapy in a single daily dose. All patients were naive to anticonvulsant therapy. The study examined both clinical effects and pharmacokinetic effects of zonisamide. Patients ranged in age from infancy (3 months) to 15 years of age, with a mean age of 8 years. All were of normal intelligence and did not have concomitant psychiatric illnesses. Thus, the group was homogeneous. Earlier studies had shown that the plasma concentration of zonisamide peaks at 4 h, and that its half-life in healthy volunteers is about 60 h. These findings were the groundwork for examining whether single-dose monotherapy of zonisamide is effective for epilepsy treatment. Patients received zonisamide in the morning at an initial dose of 2mg/kg per day, which was increased incrementally to an 8mg/kg per day maintenance dose. Blood samples were taken to determine trough and peak plasma levels of the drug. Pharmacokinetic studies showed plasma level-to-dose ratios increased with age, but peak-to-trough plasma level ratios did not. Dr. Miura and colleagues found that 57 of the 72 patients (79%) achieved complete seizure control over a treatment period of 6–43 months (mean 27 months). Efficacy data showed that the therapeutic range is somewhere from 15 to 40 g/mL, with 15 g/mL being subtherapeutic for seizure control in many, and 40 g/mL being toxic in others. Low
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ورودعنوان ژورنال:
- Seizure
دوره 13 شماره
صفحات -
تاریخ انتشار 2004