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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by SalArmy4me on August 10, 2001, at 19:25:18
I'm starting this drug today. Has anyone tried it?
Department of Neuropsychiatry, School of Medicine, Hirosaki University, Japan. [Effects of carbamazepine and zonisamide on acetylcholine levels in rat striatum]. [Japanese]
Nihon Shinkei Seishin Yakurigaku Zasshi. 17(1):17-23, 1997 Feb:"These results indicate that effective doses of CBZ and Zonisamide (ZNS) enhance ACh turnover and extracellular levels of ACh, while toxic doses of CBZ and ZNS (100 mg/kg) decrease them without affecting cholinesterase activity. The effects of CBZ and ZNS on ACh levels may, at least partly, explain the antiepileptic and mood stabilizing effects of these drugs...."
Department of Neuro-psychiatry, Keio University School of Medicine, Tokyo, Japan. The first open study of zonisamide, a novel anticonvulsant, shows efficacy in mania. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 18(4):707-15, 1994 Jul:
"Zonisamide, an anticonvulsant developed in Japan, is structurally similar to serotonin. Zonisamide has been proven to have a pharmacological profile that is very similar to that of carbamazepine. Thus, the effect of zonisamide was examined in 24 psychiatric patients: 15 with bipolar manic state, 6 with schizoaffective manic state, and 3 schizophrenic excitement. 2. Approximately 25% of all the patients and 33% of the bipolar manic patients showed remarkable global improvement with the addition of zonisamide. Approximately 71% of all the patients and 80% of the bipolar group had more than moderate global improvement. 3. No serious adverse reactions were found and no patients required zonisamide withdrawal..."
Posted by adamie on August 10, 2001, at 19:34:04
In reply to Zonisamide for Depression, posted by SalArmy4me on August 10, 2001, at 19:25:18
> I'm starting this drug today. Has anyone tried it?
>
> Department of Neuropsychiatry, School of Medicine, Hirosaki University, Japan. [Effects of carbamazepine and zonisamide on acetylcholine levels in rat striatum]. [Japanese]
> Nihon Shinkei Seishin Yakurigaku Zasshi. 17(1):17-23, 1997 Feb:
>
> "These results indicate that effective doses of CBZ and Zonisamide (ZNS) enhance ACh turnover and extracellular levels of ACh, while toxic doses of CBZ and ZNS (100 mg/kg) decrease them without affecting cholinesterase activity. The effects of CBZ and ZNS on ACh levels may, at least partly, explain the antiepileptic and mood stabilizing effects of these drugs...."
>
> Department of Neuro-psychiatry, Keio University School of Medicine, Tokyo, Japan. The first open study of zonisamide, a novel anticonvulsant, shows efficacy in mania. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 18(4):707-15, 1994 Jul:
>
> "Zonisamide, an anticonvulsant developed in Japan, is structurally similar to serotonin. Zonisamide has been proven to have a pharmacological profile that is very similar to that of carbamazepine. Thus, the effect of zonisamide was examined in 24 psychiatric patients: 15 with bipolar manic state, 6 with schizoaffective manic state, and 3 schizophrenic excitement. 2. Approximately 25% of all the patients and 33% of the bipolar manic patients showed remarkable global improvement with the addition of zonisamide. Approximately 71% of all the patients and 80% of the bipolar group had more than moderate global improvement. 3. No serious adverse reactions were found and no patients required zonisamide withdrawal..."hi. A while ago you mentioned you ordered Reboxetine from Mexico. I was just wondering if you had tried it and if so how it went for you.
Posted by Mitch on August 11, 2001, at 0:18:02
In reply to Zonisamide for Depression, posted by SalArmy4me on August 10, 2001, at 19:25:18
> I'm starting this drug today. Has anyone tried it?
>
> Department of Neuropsychiatry, School of Medicine, Hirosaki University, Japan. [Effects of carbamazepine and zonisamide on acetylcholine levels in rat striatum]. [Japanese]
> Nihon Shinkei Seishin Yakurigaku Zasshi. 17(1):17-23, 1997 Feb:
>
> "These results indicate that effective doses of CBZ and Zonisamide (ZNS) enhance ACh turnover and extracellular levels of ACh, while toxic doses of CBZ and ZNS (100 mg/kg) decrease them without affecting cholinesterase activity. The effects of CBZ and ZNS on ACh levels may, at least partly, explain the antiepileptic and mood stabilizing effects of these drugs...."
>
> Department of Neuro-psychiatry, Keio University School of Medicine, Tokyo, Japan. The first open study of zonisamide, a novel anticonvulsant, shows efficacy in mania. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 18(4):707-15, 1994 Jul:
>
> "Zonisamide, an anticonvulsant developed in Japan, is structurally similar to serotonin. Zonisamide has been proven to have a pharmacological profile that is very similar to that of carbamazepine. Thus, the effect of zonisamide was examined in 24 psychiatric patients: 15 with bipolar manic state, 6 with schizoaffective manic state, and 3 schizophrenic excitement. 2. Approximately 25% of all the patients and 33% of the bipolar manic patients showed remarkable global improvement with the addition of zonisamide. Approximately 71% of all the patients and 80% of the bipolar group had more than moderate global improvement. 3. No serious adverse reactions were found and no patients required zonisamide withdrawal..."
The adverse event section in the monograph for zonisamide (Zonegran, US) also shows a lot of cognitive adverse events, statistically significant rates of rash, and "schizophreniform" events. I was offered it a few months ago and declined after reading the insert. I want a little more data first. Nowadays, a new med starts off with a lot of wondrous promises and few side effects and usually with time you start seeing the realities. Are there any other studies that would help bolster the positive tone of this one?Mitch
Posted by SalArmy4me on August 12, 2001, at 9:09:56
In reply to Re: Zonisamide for Depression » SalArmy4me, posted by Mitch on August 11, 2001, at 0:18:02
This is my second day on Zonisamide. I take it all at bedtime. So far the Zonisamide is completely tolerable, even at the 400 mg megadose I'm taking to start with. I haven't noticed any side-effects. This is similar to the experience I had on Lamictal in in terms of lack of side-effects.
Posted by Mitch on August 12, 2001, at 11:54:24
In reply to Re: Zonisamide for Depression, posted by SalArmy4me on August 12, 2001, at 9:09:56
> This is my second day on Zonisamide. I take it all at bedtime. So far the Zonisamide is completely tolerable, even at the 400 mg megadose I'm taking to start with. I haven't noticed any side-effects. This is similar to the experience I had on Lamictal in in terms of lack of side-effects.
S4me,
I was asked if I wanted to start it at 100mg at bedtime. I wonder what all the cognitive sfx is about in the insert, though. I am real sensitive to meds and it just scared me I guess. Neurontin is the only mood stabilizer I can take that actually helps my attention/cognition, etc. BUT, it doesn't work well enough by itself to control my highs. I am taking a little Depakote with it, but it "blurrs" my consciousness and causes tremor (so does Lithium and others). I might give the Zonegran a trial as a possible substitute for my Depakote.
Does the Zonegran appear to be activating? I can't take something that is TOO activating.
Mitch
Posted by Zo on August 12, 2001, at 23:52:36
In reply to Zonisamide for Depression, posted by SalArmy4me on August 10, 2001, at 19:25:18
> I'm starting this drug today. Has anyone tried it?
>No, but I'm thinking of it, after reading the help it offers for BPII, so keep us posted!
Zo
Posted by Whit on December 12, 2002, at 18:04:07
In reply to Zonisamide for Depression, posted by SalArmy4me on August 10, 2001, at 19:25:18
My doc started me on Zonegran today (12/12/2002). He hopes it will have a mood stabilizing affect that does not make me depressed as the other anticonvulsants did. I don't see much on the net about real experiences with this drug so I would love to hear from anyone else taking it for bipolar II or other mood disorders.
Posted by Ritch on December 12, 2002, at 23:30:23
In reply to Re: Zonisamide for Depression, posted by Whit on December 12, 2002, at 18:04:07
> My doc started me on Zonegran today (12/12/2002). He hopes it will have a mood stabilizing affect that does not make me depressed as the other anticonvulsants did. I don't see much on the net about real experiences with this drug so I would love to hear from anyone else taking it for bipolar II or other mood disorders.
I haven't heard much either about it (even for epilepsy which it is indicated for) since it was introduced. I was concerned about the side effects after reading the monograph on it. I can't remember offhand whether it was a significant minor likelihood of cognitive adverse events/psychosis or the rash thing you hear about with other anticonvulsants. Could you tell us how much you are taking and what other meds are in the mix(if you don't mind)? From what I remember there were only 100mg capsules with a relatively long half-life, so you only needed to take them at bedtime. What other antimanics have you been on previously?
Posted by Whit on December 13, 2002, at 7:49:31
In reply to Re: Zonisamide for Depression » Whit, posted by Ritch on December 12, 2002, at 23:30:23
> > My doc started me on Zonegran today (12/12/2002). He hopes it will have a mood stabilizing affect that does not make me depressed as the other anticonvulsants did. I don't see much on the net about real experiences with this drug so I would love to hear from anyone else taking it for bipolar II or other mood disorders.
>
> I haven't heard much either about it (even for epilepsy which it is indicated for) since it was introduced. I was concerned about the side effects after reading the monograph on it. I can't remember offhand whether it was a significant minor likelihood of cognitive adverse events/psychosis or the rash thing you hear about with other anticonvulsants. Could you tell us how much you are taking and what other meds are in the mix(if you don't mind)? From what I remember there were only 100mg capsules with a relatively long half-life, so you only needed to take them at bedtime. What other antimanics have you been on previously?I have taken pretty much all of the mood stabilizers previously (lithium, depakote, lamictal, neurontin). I don't have much of a problem with manic episodes and these meds just seemed to keep me dysthymic all the time. I have also taken pretty much everything for depression with the exception of MAOIs and tricyclics, again with little success. I am now taking 60 mg of Adderall XR to fight depression along with 10 mg Zyprexa and the new addition Zonegran. My doc started me at 100 mg Zonegran and I am supposed to go to 200 mg after 2 weeks with additional increases to follow. I am not sure what his target dosage is for me.
This is the end of the thread.
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