Zonisamide (Zonegran)

Zonisamide is being mentioned in multiple articles in the psychiatric literature as a potential medication for bipolar disorder.  There is a 24-patient open trial from Japan from 1994 claiming zonisamide helped some patients.  There is also a single case report from Canada.  While Keio University School of Medicine psychiatrists in Tokyo claim that their open trial proves that zonisamide helped mania in bipolar, schizoaffective, and agitated schizophrenic patients, efficacy cannot be established by open trials.  

I would strongly recommend that zonisamide not be used until someone does at least one double-blind study.  Two or more would be better.  For those interested in the foolishness of following the findings of open trials, I would refer you to the Gabapentin Scandal and Open Trial webpages on this website.  Indeed, I consider it unethical and malpractice to experiment on patients, giving them powerful medications and potentially dangerous side-effects without either prior double-blind studies proving their efficacy or the safeguards of signed, informed consent and a supervising Institutional Review Board (IRB).