Document Type


Publication Date

March 2006


This article has been peer reviewed. It is the authors' final version prior to publication in Cephalalgia 26(10):1199-1202, October 2006. The definitive version is available at ( Copyright (c) 2006 by Blackwell Publishing, Inc.


Zonisamide, a new antiepileptic drug, has been approved in the US as adjunctive therapy for the treatment of partial seizures in adults.1,2 Chemically a sulfonamide analogue, zonisamide is thought to have several mechanisms of action, including a rate-dependent blockade of voltage-gated sodium channels and reduction of ion flow through T-type calcium channels.3-5 It is also a weak carbonic anhydrase inhibitor. Zonisamide has a favorable pharmacokinetic profile that includes high oral bioavailability and a long half life (63 hours), permitting a once- or twice-daily dosing regimen.6

There are only a limited number of current migraine preventive medications that have proven efficacy. Their use is often limited because of adverse events (AEs) in a significant number of patients.7 Because of its pharmacologic properties, zonisamide is potentially an effective drug for migraine prevention, and preliminary data suggest that it may be effective for this indication.8-10 The long half life of the drug makes it a good candidate for migraine patients who have poor compliance to preventive therapy that involves multiple daily dosing.

The aim of this study was to evaluate the efficacy and tolerability of zonisamide for migraine prophylaxis in refractory patients attending a tertiary headache center.

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