Zonisamide (All indications)

Exposed non-exposed studies (cohort)

Study Country
Study period
Population source Exposure definition Non-exposure definition Sample size Rmk
Battino (Zonisamide) (Epilepsy), 2024 Worldwide (47 countries)
1999 - 2022
Pregnant women with epilepsy exposed to antiseizure medications at the time of conception and enrolled within the 16th week of gestation, where fetal outcome had not yet been determined. Pregnant women with epilepsy exposed to Zonisamide monotherapy at the time of conception. exposed to other treatment, sick
Pregnant women with epilepsy exposed to lamotrigine monotherapy at the time of conception.
29 / 3584 Overlapping: Battino 2024 (1999-2022) updates and totally includes Tomson 2018 (1999-2016) and Jimenez 2020 (1 center in Spain 2000-2018) => Use of Battino 2024 for the 8 (plus 16 in eSupp) ASM monotherapies studied here.
Hernández-Díaz (Zonisamide), 2017 United States and Canada
1997 - 2017
Singleton, nonmalformed liveborn infants whose mothers had complete follow-up data. Infants born to women who used zonisamide in monotherapy throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants born to women who used lamotrigine in monotherapy throughout pregnancy.
125 / 1799 'Most women used their AED throughout pregnancy. The exception was topiramate'. The main indications for AED were epilepsy (91%).
Hernández-Díaz (Zonisamide) (Controls exposed to Lamotrigine, sick), 2014 United States and Canada
1997 - 2012
Women who had singleton, nonmalformed liveborns and who had complete follow-up data. Infants of women exposed to zonisamide for epileptic indication as monotherapy throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women exposed to lamotrigine for mixed indications as monotherapy throughout pregnancy.
98 / 1581 Less than 90% of women are taking Lamotrigine for epilepsy. A more recent publication Hernández-Díaz 2017 gives a better review of the outcome 'small for gestational age'. Most women used their antiepileptic drug throughout pregnancy.
Hernández-Díaz (Zonisamide) (Controls unexposed, disease free), 2014 United States and Canada
1997 - 2012
Women who had singleton, nonmalformed liveborns and who had complete follow-up data. Infants of women exposed to zonisamide as monotherapy throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infants of pregnant women not taking an antiepileptic drugs and without epilepsy who had been recruited among the friends and relatives of antiepileptic drugs-exposed participants.
98 / 457 Most women used their antiepileptic drug throughout pregnancy. A more recent publication (Hernández-Díaz 2017) gives a better review for the outcome 'small for gestational age'.
Källén (Zonisamide) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Swedish
1996 - 2011
Nearly all births in Sweden during the study period (1,575,847) are registered in The Swedish Medical Birth Register. Infants whose mothers used zonisamide in monotherapy in early pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants whose mothers used lamotrigine in monotherapy in early pregnancy.
3 / 1084 Indications for antiepileptic drugs are not specified. Follow-up period known thanks to author's email reply.
Källén (Zonisamide) (Controls unexposed, NOS) (Indications NOS), 2013 Swedish
1996 - 2011
Nearly all births in Sweden during the study period (1,575,847) are registered in The Swedish Medical Birth Register. Infants whose mothers used zonisamide in monotherapy in early pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Infants in population whose mothers used at least one of a central nervous system active drugs (less than 3%) or weren't exposed in early pregnancy.
3 / 1575847 Indications for antiepileptic drugs are not specified. Follow-up period known thanks to author's email reply.
Meador (Zonisamide) (Controls exposed to Lamotrigine, sick), 2021 US
2012 - 2016
Pregnant (gestational age of 20 weeks or less) women with epilepsy and healthy women were recruited from the 20 epilepsy practices and through referral from obstetricians and other physicians as well as self-referral. Children with epileptic mothers using zonisamide monotherapy in the third trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children with epileptic mothers using lamotrigine monotherapy in the third trimester.
11 / 93 Exclusion criteria included history of psychogenic nonepileptic spells, expected IQ of less than 70, other major medical illness, and switching of ASMs in pregnancy before enrollment.
Meador (Zonisamide) (Controls exposed to Lamotrigine, sick), 2020 US
2012 - 2016
Pregenant women with epilepsy were recruited primarily from the clinical populations at the 20 MONEAD sites, but also via referral from physicians, as well as self-referral. They were ages 14–45 years and ≤20 weeks gestational age. Children born to pregnant women with epilepsy exposed to zonisamide monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children born to pregnant women with epilepsy exposed to lamotrigine monotherapy during the first trimester.
13 / 113
Meador (Zonisamide) (Controls unexposed, disease free), 2021 US
2012 - 2016
Pregnant (gestational age of 20 weeks or less) women with epilepsy and healthy women were recruited from the 20 epilepsy practices and through referral from obstetricians and other physicians as well as self-referral. Children with epileptic mothers using zonisamide monotherapy in the third trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children of healthy women.
11 / 106 Exclusion criteria included history of psychogenic nonepileptic spells, expected IQ of less than 70, other major medical illness, and switching of ASMs in pregnancy before enrollment.
Meador (Zonisamide) (Controls unexposed, disease free), 2020 US
2012 - 2016
Pregenant women with epilepsy were recruited primarily from the clinical populations at the 20 MONEAD sites, but also via referral from physicians, as well as self-referral. They were ages 14–45 years and ≤20 weeks gestational age. Children born to pregnant women with epilepsy exposed to zonisamide monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children born to healthy pregnant women.
13 / 106
Meador (Zonisamide) (Controls unexposed, sick), 2020 US
2012 - 2016
Pregenant women with epilepsy were recruited primarily from the clinical populations at the 20 MONEAD sites, but also via referral from physicians, as well as self-referral. They were ages 14–45 years and ≤20 weeks gestational age. Children born to pregnant women with epilepsy exposed to zonisamide monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to pregnant women with epilepsy with no antiepileptic drug use.
13 / 15
The Australian Pregnancy Register of Antiepileptic Drugs (Mixed indications) (Controls exposed to LTG), 2024 Australia
1999 - 2023
Women with epilepsy (WWE), with voluntary inclusion, with known outcomes but in which that outcome was unknown at the time of the pregnancy’s enrolment. Women with epilepsy exposed to Zonisamide monotherapy at time of conception. exposed to other treatment, sick
Women with epilepsy exposed to Lamotrigine monotherapy at time of conception.
6 / 406 Data extracted from the publication Perucca 2024, an update of the Epilepsy-pregnancy registries, and with de-depublication of pregnancies of EURAP registry.
The Australian Pregnancy Register of Antiepileptic Drugs (Mixed indications) (Controls unexposed, sick), 2024 Australia
1999 - 2023
Women with epilepsy (WWE), with voluntary inclusion, with known outcomes but in which that outcome was unknown at the time of the pregnancy’s enrolment. Women with epilepsy exposed to Zonisamide monotherapy at time of conception. unexposed, sick
Women with epilepsy unexposed to antiseizure medication in at least the first few months of pregnancy.
6 / 207 Data extracted from the publication Perucca 2024, an update of the Epilepsy-pregnancy registries (and Vajda 2024 for the control group), and with de-depublication of pregnancies of EURAP registry.
The Kerala Registry for Epilepsy and Pregnancy (Epilepsy) (Controls exposed to Lamotrigine), 2024 India
1998 - 2023
All pregnancies with known outcomes in women with epilepsy enrolled in the registry during 1998 - 2013 and the diagnosis of epilepsy was confirmed before registration. Children of women with epilepsy using Zonisamide monotherapy any time during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children of women with epilepsy using lamotrigine monotherapy any time during the first trimester of pregnancy.
3 / 50 Data extracted from the publication Perucca 2024, an update of the Epilepsy-pregnancy registries. Study design and control data based on Thomas et al., 2017 and Thomas et al., 2021.
The Kerala Registry for Epilepsy and Pregnancy (Epilepsy) (Controls unexposed, sick), 2024 India
1998 - 2023
All pregnancies with known outcomes in women with epilepsy enrolled in the registry during 1998 - 2013 and the diagnosis of epilepsy was confirmed before registration. Children of women with epilepsy using Zonisamide monotherapy any time during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children of women with epilepsy not using any antiepileptic drugs during the first trimester.
3 / 340 Data extracted from the publication Perucca 2024, an update of the Epilepsy-pregnancy registries. Study design and control data based on Thomas et al., 2017 and Thomas et al., 2021.
The NAAED (Zonisamide) (Controls exposed to LTG) (Indications NOS), 2024 North America and Canada
1997 - 2023
Pregnant women who are taking an antiepileptic drug for any reason and had a liveborn infant, a stillborn infant, or a pregnancy terminated because of a fetal abnormality and enrolled as 'pure' or 'traditional' enrollees. Infants of pregnant women who used Zonisamide as monotherapy, during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of pregnant women who used lamotrigine as monotherapy, during the first trimester.
240 / 2461 Data extracted from the publication Perucca 2024, an update of the Epilepsy-pregnancy registries. Overlapping with Hernández-Díaz et al. 2012 and/or previous website reports.
The NAAED (Zonisamide) (Controls unexposed, disease free) (Indications NOS), 2024 North America and Canada
1997 - 2023
Pregnant women who are taking an antiepileptic drug for any reason and had a liveborn infant, a stillborn infant, or a pregnancy terminated because of a fetal abnormality and enrolled as 'pure' or 'traditional' enrollees. Infants of pregnant women who used Zonisamide as monotherapy, during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infants of pregnant women, not taking an antiepileptic drug and without epilepsy, who were recruited from among the friends and family members of the enrolled women taking an antiepileptic drug.
240 / 1311 Data extracted from the publication Perucca 2024 (for exposed pregnancies) and the North American AED pregnancy registry website (for controls). Overlapping/update with Hernández-Díaz et al. 2012 and/or previous website reports. Use of internal control.
The UKIEPR (Epilepsy) (Controls exposed to Lamotrigine), 2024 UK and Ireland
1996 - 2023
Pregnant women with epilepsy, whether or not they were taking an antiepileptic drug, either in monotherapy or polytherapy, and who were referred to the register before the outcome of the pregnancy was known. Infants of women with epilepsy exposed to Zonisamide in monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women with epilepsy exposed to lamotrigine in monotherapy during the first trimester.
25 / 2098 Data extracted from the publication Perucca 2024, an update of the Epilepsy-pregnancy registries. Study design based on Morrow 2006 and Campbell 2014.
The UKIEPR (Epilepsy) (Controls unexposed, sick), 2024 UK and Ireland
1996 - 2023
Pregnant women with epilepsy, whether or not they were taking an antiepileptic drug, either in monotherapy or polytherapy, and who were referred to the register before the outcome of the pregnancy was known. Infants of women with epilepsy exposed to Zonisamide in monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants of women with epilepsy on no antiepileptic drugs during pregnancy.
25 / 541 Data extracted from the publication Perucca 2024, an update of the Epilepsy-pregnancy registries. Study design based on Morrow 2006 and Campbell 2014.

Case-control studies (cohort)

Study Country
Study period
Case Control Sample size Rmk

master protocol