Abstracts

Epilepsy is common in developmental disabled (DD) or mentally retarded (MR) patients, yet few studies specifically address the experience with antiepileptic medications (AEDs) in this special patient population. This study is to assess the response to Zonisamide (ZNS) in patients with DD / MR. A retrospective review was made of all DD / MR patients treated with ZNS as adjunctive therapy from July 2000 to March 2004 at the Long Island Jewish Comprehensive Epilepsy Center. Eighteen patients (8 male, 10 female) have been identified so far. The median age was 40.5 years (range, 21-62 years). Median ZNS dose was 350 mg/day (range, 100-600 mg/day). Patients[apos] duration of ZNS exposure ranges from 1.8 months to 33.6 months (median, 13.8 months). These patients had either a single or a combination of a different seizure types, including generalized tonic-clonic, complex partial, absence, atonic, tonic and myoclonic seizures. The median seizure frequencies in the 6-month periods immediately before and after ZNS treatment are 1.98/month (range, 0.62 - 82/month) and 1.23/month (range, 0 - 12.9/month), respectively. 12 patients (66.7%) demonstrated a reduction in overall seizure frequency after ZNS treatment (median daily dose 300 mg; range 100-600 mg). Out of these 12 patients, eight experienced [gt]50% reduction and four experienced [lt]50% reduction in seizure frequency. Five patients (27.8%) reported increased seizures, and the seizure frequency change in one patient (5.6%) is unknown. The overall improvement in seizure control in patients while taking ZNS is statistically significant (p [lt] 0.05). Adverse reactions were reported in nine patients while taking ZNS (median daily dose 300 mg, range 100-400 mg). Two patients demonstrated behavioral or mood symptoms. One of them had a history of behavioral disorder, and symptom abated spontaneously in the other patient. Other adverse reactions reported included 3 patients with tremors (one of them has Alzheimer[apos]s disease), 3 patients with fatigue or drowsiness, 2 patients with gastrointestinal (GI) upset, 1 patient with dizziness. Similar to the experience in the general epilepsy population, Zonisamide is an efficacious and generally well-tolerated treatment for epilepsy patients with developmentally disabilities or mental retardation. (Supported by Elan Pharmaceuticals, Inc.)