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
September 17, 2026
Music and Pain
Music can relieve pain, but what kind of music? A new study from McGill University, published in Pain, found that music with greater emotional depth reduced pain, while intense, forceful music increased it. The effect seemed to depend on how much listeners enjoyed the music. The practical advice: choose music you love, rather than music labeled relaxing or therapeutic.
Read article
September 10, 2026
Brain disorders
Genetic connection of fibromyalgia with low back pain, PTSD, IBS, and other disorders.
A genome-wide study published in Nature Medicine found that fibromyalgia shares genetic risk factors with chronic pain conditions, IBS, PTSD, and sleep disturbances. This supports treating these overlapping conditions as one problem of a hyperexcitable nervous system rather than as separate diseases, using a multidisciplinary approach that combines psychological therapies with medications, injections, and neurostimulation.
Read article
Insights from Dr. Alexander Mauskop on headaches and migraines
Subscribe to the Blog.
Subscribe
Subscribe