Zonegran (Zonisamide)
What is Zonegran?
Zonegran is a medication we prescribe to help patients with weight loss. Originally, Zonegran was used as an anti-seizure medication. However, when doctors gave Zonegran to children for seizures, they stopped eating. Today, it is prescribed by itself or in combination with other medications for effective weight loss. A pharmaceutical company who specializes in making weight loss medications has combined Zonegran with Wellbutrin, and the combination pill is in phase 2 of the FDA approval process. In studies, 83% of patients lost significant weight with the combo pill and the average weight loss was 9.9% … versus only 1.7% with placebo.
How does Zonegran help me lose weight?
Zonegran increases monoamines, which suppress the NPY and AgRP neurons in the hypothalamus that stimulate the appetite. Zonegran may also stimulate the pro-opiomelanocortin receptors in the hypothalamus which suppress the appetite.
What are some side-effects?
Most patients experience no side effects. However, since the appetite centers are located in the brain and the seizure centers are also located in the brain, for those patients who do experience side-effects, most side effects involve the brain. (Our patients haven’t complained of heart problems or bowel problems.) Watch for any kind of side-effects that are brain-related … like hearing, vision, mood, sleep, fatigue, taste, dizziness, balance, concentration, and so on. Many patients cannot specifically explain their side effects. They simply state, “I didn’t like the way I felt when I went up to six pills.” If you experience a rash of any type, stop Zonegran immediately and call us. Zonegran can cause a severe and rarely fatal allergic skin reaction called toxic epidermal necrolysis or Stevens-Johnson syndrome. Zonegran may also cause metabolic acidosis which may slightly increase the risk of kidney stones. Zonegran can decrease sweating which can increase the risk of heat stroke during very hot weather. Don’t become pregnant while taking Zonegran because Zonegran may cause harm to the fetus. Note: this information is not a substitute of the pharmacy drug education handout, so please ask the pharmacist for a complete patient handout.
What results have you seen at the Institute?
Most of our patients do very well with weight loss after starting Zonegran. Some patients also have difficulties explaining the effectiveness of Zonegran by saying, “I don’t know how it works, but I’m losing ten pounds a month.” One patient tried a different medication each month for several months and reached a plateau after losing 40 pounds. Once the patient started Zonegran, she lost another 20 pounds in two months. Another patient was able to lose over 72 pounds by taking only Zonegran without side effects. She told us, “I don’t feel like I’m taking any medicine at all.” But she also felt it wasn’t suppressing her appetite … she just lost weight.
How do I take Zonegran?
Zonegran is available in 100 mg pills. For the first week, take one pill at bedtime. For the second week, take two pills at bedtime. For the third week, take three pills at bedtime. Keep increasing the amount of pills taken by one per week. If you develop a side effect, do not stop the medication, but simply return to the previous dose. For example, if you are taking three pills and you don’t feel right, don’t stop the medication, just go down to two pills. Since Zonegran is a generic medication, it is relatively inexpensive and costs less than twenty dollars without insurance.