Pill That Helps Take the Weight Off

Zonisamide daily dose can help with weight loss with healthy diet and exercise

/ Author:  / Reviewed by: Chris Galloway, M.D. Beth Bolt, RPh

(RxWiki News) Medications are often a last resort in people’s attempts to lose weight. While some consumers are weary about whether medications actually work, there’s one medicine that could effectively help shed the pounds.

A recent review of a 2003 study found that a 400 milligram daily dose of the medicine zonisamide (brand name Zonegran) effectively helped people lose weight.

Individuals who took 400 milligrams of zonisamide combined with a healthy diet and exercise lost on average about 16 pounds. 

"Talk to your doctor first before taking any diet medications."

Caroline M. Apovian, MD, and Louis Aronne, MD, from Boston University School of Medicine and Weill Cornell Medical College, reviewed a 2003 investigation by Kishore Gadde, MD, of Duke University, that looked at how well zonisamide, an antiepileptic medication, helped obese individuals lose weight. Antiepileptic medicines prevent and treat convulsions (when the body shakes rapidly and uncontrollably).

The 225 participants who were involved in Dr. Gadde’s study were divided into one of three groups between January 2006 and September 2011. These participants did not have type 2 diabetes, and about 60 percent of them were women.

One group of participants was given a placebo, or a fake pill, to take once a day for a year. A second group received 200 milligrams of zonisamide to take each day for a year, and a third group received 400 milligrams of the medication each day for a year.

The participants had an average body mass index (BMI) of 37.6, which classified them as obese. BMI is a measure of height and weight together that determines whether individuals are within a normal weight range, overweight or obese.

All three groups were also given diet and lifestyle counseling by a dietitian and had their weight recorded throughout the course of the study at Duke University Medical Center.

By the end of the study, about 97 percent of the patients completed the one-year follow-up assessment.

At that time, the researchers found that patients in the group who took 400 milligrams of zonisamide lost the most weight of the three groups. Patients in that third group lost about 16 pounds on average.

Patients in the second group, who took 200 milligrams of zonisamide, lost 9.7 pounds on average. And patients in the first group who took the placebo lost about 8.8 pounds on average. The differences in weight between the first and second groups were not statistically significant.

The researchers found that about 31 percent of the placebo group lost at least 5 percent of their body weight. Among those who took the zonisamide, about 34 percent of the 200 milligram group and 55 percent of the 400 milligram group lost at least 5 percent of their body weight.

About 8 percent of the placebo group lost at least 10 percent of their body weight, while 22 percent of the 200 milligram group and 32 percent of the 400 milligram group lost at least 10 percent of their body weight.

Although the zonisamide groups lost more weight than the placebo group, those who took the medication experienced more gastrointestinal, nervous system and psychiatric side effects.

As is the case for the treatment of many other clinical conditions, the authors of the review said that treatment is only effective if patients stick to it as recommended.

“Clinicians have few medications available to them to treat obesity,” the reviewers wrote in their report. “Even if a few patients benefit from a new medication, it will be well worth the effort to introduce new therapeutic options for a disease that is stubbornly refractory to treatment.”

This review was published online August 14 in the journal JAMA.

Dr. Apovian served on the advisory board and received research grants from a number of organizations and committees. She received royalties for her work in diet planning books. Dr. Aronne also served as a speaker, advisor and received research support from a number of other committees and organizations involving medication.

Review Date: 
August 14, 2013
Last Updated:
September 4, 2013