100 Migraine Drugs, A to Z: zonisamide

December 9, 2020

Zonisamide (Zonegran) is an epilepsy drug similar to topiramate in its mechanism of action. Unfortunately, it shares its side effects as well. These include fatigue, difficulty with concentration and memory, nausea, and other. However, because they are not identical drugs, some patients tolerate zonisamide better than topiramate.

One study showed that 44% of 172 patients who did not respond to topiramate did respond to zonisamide with 13% having an excellent response. A similar study in 63 patients who did not respond to topiramate also showed benefit from zonisamide as did 34 patients in another study. Zonisamide also helped 8 out of 12 children who did not respond to other medications.

The dose of zonisamide ranges from 50 to 400 mg a day, but most patients need 100-200 mg.

Written by
Alexander Mauskop, MD
Continue reading
May 21, 2026
Research
Your Brain Has Many Pathways, And TMS Can Now Use Them
A groundbreaking University of Iowa study shows that personalized fMRI-guided TMS can now reach and modulate the deep hippocampus — the brain’s command center for memory, emotion, and migraine — without surgery or heavy medications. By mapping each patient’s unique neural pathways, TMS delivers precise stimulation to surface “control points” that influence deep brain structures. Generic approaches barely work, but individualized targeting produces clear, measurable changes. At our headache clinic, we combine TMS and fMRI to offer this advanced, personalized treatment for migraines, depression, PTSD, anxiety, and more.
Read article
May 10, 2026
Research
Elismetrep: A Promising New Experimental Migraine Treatment
Elismetrep is a promising experimental migraine medication that targets the TRPM8 pathway rather than serotonin or CGRP. Early clinical trials suggest it may offer a new option for patients who do not respond well to current treatments.
Read article
May 6, 2026
Alternative Therapies
New Research on Brain Excitability and TMS Treatment for Migraine
New research shows how the brain dynamically regulates excitability in real time—and why this matters for transcranial magnetic stimulation (TMS) as a treatment for migraine.
Read article
Insights from Dr. Alexander Mauskop on headaches and migraines
Subscribe to the Blog.
Subscribe
Subscribe