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The antiepileptic drug zonisamide enhances the efficacy of weight loss regimens, but data about optimal dosing in relation to adverse effects have been inconclusive. In this trial, investigators randomized 225 obese adults (mean age, 43; 60% women; mean body-mass index, 38 kg/m2) to zonisamide (200 or 400 mg daily) or placebo for 1 year. Patients with diabetes, unstable medical illnesses, or major psychiatric illnesses were excluded. All participants received counseling about diet and exercise.
Of 218 evaluable participants, those who received 400-mg zonisamide lost significantly more weight than those who received placebo (7.3 vs. 4.0 kg), but those who received 200-mg zonisamide did not (4.4 kg). Participants in the 400-mg group also were …