Abstracts

Rationale: People with epilepsy tend to be more obese and use of several antiepileptic drugs (AEDs) may be associated with weight gain. Because iatrogenic obesity may contribute to reduced compliance to medication, it would be reasonable approach to consider AEDs that promote weight loss in obese patients. We performed an open-labeled, observational study to assess the effects of zonisamide on weight in first-diagnosed overweight female epilepsy patients, and studied the role of serum leptin level before treatment in weight change in these patients.Methods: We prospectively included first-diagnosed female epilepsy patient with basal body mass 25 or more. Zonisamide was administered as monotherapy up to 400mg/day, and we measured changed in body weight and various laboratory findings six months after initiation of zonisamide. Results: A total 37 female epilepsy patients were first enrolled to the study, and 23 patients completed 6 month zonisamide treatment. Baseline serum leptin level was highly correlated with initial weight (p=0.042), follow-up weight (p=0.005), and weight reduction (p=0.020), but was not correlated with patients age, dosage of zonisamide, and results of lipid battery. The correlation of baseline serum leptin level with weight reduction was still significant after the effect of initial weight was adjusted (p = 0.047).Conclusions: Our study shows that low basal serum leptin level is predictive of weight reduction in overweight female epilepsy patients. This result may give useful information in selecting AEDs and give some clue in the pathophysiology of zonisamide-induced weight reduction.