Swiss Toxicological Information Centre, Zurich, Switzerland.
Epilepsy Behav. 2011 May;21(1):91-3. doi: 10.1016/j.yebeh.2011.02.023. Epub 2011 Apr 3.
Zonisamide is an antiepileptic drug that acts on voltage-sensitive sodium and calcium channels, with a modulatory effect on GABA-mediated neuronal inhibition and an inhibitory effect on carbonic anhydrase. It is used mainly for the treatment of partial seizures, and is generally well tolerated at therapeutic doses. The most common reported adverse effects are somnolence, anorexia, dizziness, and headache. There are limited data on zonisamide overdose in the literature, and no case of zonisamide mono-intoxication has been published to date. We describe the first case of zonisamide mono-intoxication in a 25-year-old woman who ingested 12.6 g of this substance with suicidal intent. Despite a plasma zonisamide concentration of 182 mg/L on admission, the patient exhibited a benign clinical course with vomiting and central nervous system depression, requiring brief intubation. Somnolence persisted for 50 hours, and normal-anion-gap metabolic acidosis and polyuria for several days. Complete recovery may be expected with supportive care, even after ingestion of large zonisamide overdoses.
唑尼沙胺是一种抗癫痫药物，作用于电压敏感性钠和钙通道，对 GABA 介导的神经元抑制具有调节作用，并对碳酸酐酶具有抑制作用。它主要用于治疗部分性癫痫发作，在治疗剂量下通常具有良好的耐受性。最常见的不良反应报告为嗜睡、食欲不振、头晕和头痛。文献中关于唑尼沙胺过量的资料有限，迄今为止尚无唑尼沙胺单剂量中毒的病例报道。我们描述了首例有自杀企图的 25 岁女性服用 12.6 克唑尼沙胺导致单剂量中毒的病例。尽管入院时患者的血浆唑尼沙胺浓度为 182mg/L，但表现为呕吐和中枢神经系统抑制的良性临床过程，需要短暂插管。嗜睡持续了 50 小时，正常阴离子间隙代谢性酸中毒和多尿持续了数天。即使摄入大剂量唑尼沙胺，支持治疗也有望完全恢复。
