<p><strong>Human Experience</strong>: Experience with Zonisamide daily doses over 800 mg/day is limited. During Zonisamide clinical development, three patients ingested unknown amounts of Zonisamide as suicide attempts, and all three were hospitalized with CNS symptoms. One patient became comatose and developed&nbsp;bradycardia,&nbsp;hypotension, and&nbsp;respiratory depression; the zonisamide plasma level was 100.1 &mu;g/mL measured 31 hours post-ingestion. Zonisamide plasma levels fell with a half-life of 57 hours, and the patient became alert five days later.<br />
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<strong>Management</strong>: No specific antidotes for Zonisamide overdosage are available. Following a suspected recent overdose,&nbsp;emesis&nbsp;should be induced or&nbsp;gastriclavage performed with the usual precautions to protect the airway. General&nbsp;supportive care&nbsp;is indicated, including frequent monitoring of vital signs and close observation.<br />
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Zonisamide has a long half-life. Due to the low protein binding of zonisamide (40%), renal&nbsp;dialysis&nbsp;may be effective. The effectiveness of renal dialysis as a treatment of overdose has not been formally studied. A poison control center should be contacted for information on the management of Zonisamide overdosage.</p>