Zonisamide for Weight Loss: A Comprehensive Guide| 2023

Zonisamide has been shown to help obese people lose a lot of weight, which makes it an appealing alternative to more traditional ways of losing weight. But one key question when using zonisamide for weight loss is: Is zonisamide safe? This article reviews the antiepileptic drug zonisamide for weight loss while discussing any associated adverse circumstances.

Zonisamide for weight loss: Background and research

Zonisamide was initially designed to treat epilepsy; however, recent research indicates it can also aid weight loss alongside lifestyle and diet-related counseling. The effectiveness of Zonisamide for weight loss has been demonstrated through many studies.

A study found that people taking 200 mg zonisamide experience an average weight loss of 4.4 kilograms versus those taking placebo (4.0 kilograms)

The most significant changes were seen among those receiving a 400mg dose of zonisamide, who experienced consequential weight loss of -7.3 kg.

These results illustrate the usefulness of Zonisamide for weight loss when taken appropriately, providing hope to those struggling with weight gain.

Zonisamide for weight loss – How does it work?

A question arises: how does zonisamide work for weight loss?  Well, the exact mechanism of action of zonisamide is unknown, but it is thought to work by the following two means:

  1. Suppressing Neurotransmitters: Zonisamide decreases appetite by inhibiting certain neurotransmitters in the hypothalamus that increase hunger.
  2. Stimulates Receptors: Zonisamide activates receptors in the hypothalamus that suppress appetite.

Zonisamide for Weight Loss: Dosage and Administration

Let’s talk about how much zonisamide to take to lose weight:

Zonisamide comes in 100 mg tablets and follows a strict dosage schedule; it is recommended that Zonisamide 100 mg for weight loss be taken one pill nightly for the first week.

After the initial week, the dosage should gradually increase to two pills, and by week three should be recommended as necessary for maximum treatment efficacy.

Each week after that will enable your body to adapt gradually to zonisamide.

If Zonisamide causes any side effects, you shouldn’t stop taking it suddenly. Instead, slowly lower the dose until it’s back in a range you can handle. i.e., If a patient feels unease after taking three pills, reducing it to two may help.

While Ozempic and Mounjaro are rare drugs that are not covered by insurance, Zonisamide is a common drug that generally costs less than twenty dollars.

zonisamide for weight loss

Harmful Effects of Zonisamide for Weight Loss

Zonisamide does have side effects, just like any other drug treatment. You should be aware of the following side effects when using Zonisamide to lose weight.

Gastrointestinal side effects

  • Nausea
  • Diarrhea

These side effects were more frequently reported among those receiving 400 mg of Zonisamide.

Nervous System

  • Dizziness
  • Drowsiness
  • irritability

It would be best if you thought about these side effects because they could make it much harder for you to follow your treatment plans and stay healthy in general.


  • Mood disturbances
  • Anxiety
  • Depression
  • Abnormal thinking
  • Confusion

These Psychological side effects raise concerns over drug safety and appropriateness for some patients with histories of mental disorders.

Rare Side effects

  • Toxic epidermal necrolysis or Stevens-Johnson syndrome: A potentially life-threatening allergic skin reaction.
  • Metabolic acidosis: can marginally elevate the risk of kidney stone formation.
  • Reduced sweating: This may elevate the risk of heat stroke, particularly during hot weather.
  • The person who is taking Zonisamide should also not get pregnant because it can hurt the baby.


People can lose weight with zonisamide, a potent drug that has become an essential part of the fight against obesity.

Some hormones make you hungry that are turned off, and receptors in the brain are turned on. This makes it work.

But, like any drug, it might have side effects. People have said that it causes stomach pain, problems with the nervous system, and mental health problems like anxiety, sadness, and mood swings.

This drug might look like a great way to lose weight. There are still important things to keep in mind about these possible side effects and the patient’s medical background, especially if they have a history of mental illnesses.


Q.1 How much weight will I lose on zonisamide?

Patients on a 400mg daily dosage of zonisamide, an anticonvulsant drug, experienced an average weight reduction of nearly 7.5 pounds more than those solely relying on dietary counseling over one year. A separate research investigation reported an average weight loss of 9.2 kg (around 20.3 lbs.) by week 32 for the zonisamide group. It’s critical to remember the weight loss impact is subject to variances based on personal attributes such as dietary habits, physical activity levels, and overall wellness. Given the potential for side effects, zonisamide should be taken strictly under the guidance of a qualified healthcare practitioner.

Q.2 Can zonisamide cause hair loss?

It’s not known if the drug zonisamide can cause hair loss. A clinical trial in phase IV discovered that hair loss was more prevalent in females aged 50 to 59 who have taken the medication for between 1 and 6 months. In a study, out of 8,997 patients who experienced adverse reactions while taking Zonisamide, 134 (1.49 percent) suffered from hair loss.

Other factors may be responsible for this loss of hair. Although, even if it is true that Zonisamide is accountable for hair loss, the odds are much less than 2%.

Q.3 How much zonisamide is safe?

Initial Dose: Recommended dosage can range between 100 milligrams daily for adults and 2-4 mg/kg of body weight daily for children.

Titration: After two weeks at 100 mg/day, the dose can be increased gradually over two weeks to 200 mg either in one dose or split (100 mg taken orally twice daily) up to 400 mg in either one or both daily doses, for at least two weeks until reaching an equilibrium state.

Maintenance Dose: the usual maintenance dose equates to 400 mg daily.

Maximum dose: Zonisamide should not exceed 600 mg. These dosages should only be considered general guidelines; an experienced healthcare provider can determine your exact dosage.

Q.4 Does zonisamide affect sleep?

Yes, zonisamide may cause sleep disruptions. One of its typical side effects is drowsiness.

Q.5 Does zonisamide affect the heart?

Yes, very rarely, it can affect the heart. One of the more serious adverse side effects associated with zonisamide is an increased heart rate. It can also trigger signs of metabolic acidosis, for example, irregular heartbeats.

Q.6 To lose weight, bupropion and zonisamide are used. Which one is better?

It is being looked into how bupropion and zonisamide can help people lose weight. But their effectiveness can change depending on your food, exercise, and overall health.

Bupropion: Clinically, it results in significant weight loss combined with a healthy diet and exercise routine. It lowers body weight for patients with diabetes. However, a substantial number of patients will experience adverse reactions.

Zonisamide: The group showed an average weight reduction of 9.2 kilograms (approximately 20.3 pounds) in week 32. Zonisamide was well-tolerated with only a few negative consequences.

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