Scientific Last Updated: 2012-10-17 18:55:03 -0400 (Reuters Health) By Genevra Pittman NEW YORK (Reuters Health) - A drug approved to stop seizures can also help people lose a few pounds if it is added to therapy and nutritional assistance, a new small test indicates. But individuals who took zonisamide also reported more unwanted effects, from vomiting and nausea to anxiety and depression. And two experts maybe not active in the research asked simply how much the medicine might actually help people in real life. Even though zonisamide is only accepted by the U.S. Drug and food Administration for seizures, doctors could prescribe it off-label - and preceding little studies and anecdotal evidence suggested it may donate to weight reduction. "There is just a bit of weight loss with this drug if it is provided for treatment of epilepsy," said lead researcher Dr. Kishore Gadde, from Duke University Clinic in Durham, New York. That could be due to its effects on dopamine and serotonin, he explained. Those two neurotransmitters influence motivation and reward pathways in mental performance, including those associated with food. Dr. Gadde said his staff wished to see if zonisamide could make weight reduction in people without epilepsy, and with the extra support of a behavioral intervention. Based on reports published with the analysis, Dr. Gadde has multiple patents for zonisamide as cure of obesity and weight gain, and he has money in a business creating a combination weight-loss drug containing zonisamide. For the newest research, funded by the National Institute of Digestive and Diabetes and Kidney Diseases, Dr. Gadde and his colleagues randomly assigned 225 obese visitors to take either 200 or 400 mg of zonisamide or placebo daily for one year. At the top of the, all members met frequently with a nutritionist and were encouraged to be more physically active. At the outset, they'd the average body mass index of 37.6. Annually later, average weight reduction was nine pounds with placebo, 10 pounds with the lower zonisamide dose, and 16 pounds with the bigger dose. Unwanted effects were most frequent on the large amount. Out of 75 people, 10 reported nausea / vomiting, 14 had headaches, 15 developed attacks, eight had impaired memory and seven reported anxiety. Dr. Gadde said it's unclear which of these were directly linked to the drug, or how much they bothered individuals. Six and between four individuals in each class, like the placebo cohort, dropped out as a result of negative effects. According to an FDA-mandated notice on the drug's name, zonisamide can cause serious skin rashes, suicidal ideas and difficulties with memory and thinking, among other possible unwanted effects. In its universal form, the drug are available for around $30 monthly. Obesity investigator Dr. Raj Padwal, from the University of Alberta in Edmonton, Canada, said the difference between the high-dose zonisamide and placebo groups in this study was "modest" at best. "Overall it is kind of a result," in the opinion of Dr. Padwal, who wasn't active in the new study. "The earlier in the day reports of zonisamide were only a little more promising, so I would define this as somewhat disappointing," he told Reuters Health. Dr. Yoni Freedhoff, from the University of Ottawa in Canada and the Bariatric Medical Institute, also said he was not amazingly impressed with the additional weight loss with zonisamide, specially because the study only lasted one year. "Although that sounds like a really long time, it is not when it concerns weight management. It's keeping the fat off that's a struggle," he said. "To be useful for medical management of people who challenge, we must see whether two, three, four, five years in the future, there is really any benefit." What is more, Dr. Freedhoff included, it seems unlikely based on the data that zonisamide would have any effect on cholesterol levels or diabetes risk. "At the conclusion of your day, there just are not any shortcuts," Dr. Freedhoff, who also did not take part in the analysis, told Reuters Health. Dr. Gadde said much larger studies, with hundreds or thousands of obese people in each treatment group, will soon be required to more demonstrably start to see the weight-loss benefits and possible dangers of zonisamide. He plans to get funding for such study from the National Institutes of Health. "The more alternatives that people have available, the higher it's planning to be for specialists along with the consumers," Dr. Gadde told Reuters Health. A mix drug including another anti-seizure medicine, topiramate, was accepted by the FDA for weight loss in July. Dr. Freedhoff said zonisamide could be ideal for people who need anti-seizure therapy but are on different epilepsy drugs which make them gain weight. The research was published online October 15 in Archives of Internal Medicines. SOURCE: http://bit.ly/TuOztq Arch Intern Med 2012. Copyright A 2012 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited minus the prior written consent of Reuters. Reuters shan't be liable for any mistakes or delays in the content, or for any steps drawn in reliance thereon. Reuters and the Reuters ball logo are registered trademarks and trademarks of the Reuters number of organizations around the globe.
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