“Homicide and Zonisamide”: a review of the literature and illustrative case report on second and third generation antiseizure medications and psychiatric effects - Takeaways - MDSpire

“Homicide and Zonisamide”: a review of the literature and illustrative case report on second and third generation antiseizure medications and psychiatric effects

  • By

  • Stefanie Nguyen

  • Thomas C. Varkey

  • Briana Khan

  • M. Christian Cornelius

  • June 1, 2026

  • 0 min

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  • 1

    Cerebral cavernous malformations (CCMs) can lead to focal epilepsy and require long-term management with antiseizure medications (ASMs).

  • 2

    Zonisamide use was associated with homicidal ideation in a patient with a history of psychiatric disorders and cavernous malformation.

  • 3

    This case is the first to document homicidal ideation as an adverse effect of zonisamide, highlighting the need for careful monitoring.

  • 4

    Psychiatric adverse effects (PAEs) of ASMs include aggression and psychosis, particularly in patients with pre-existing psychiatric conditions.

  • 5

    The intersection of epilepsy, structural brain pathology, and ASM-related PAEs presents a complex challenge requiring multidisciplinary management.

Original Source(s)

“Homicide and Zonisamide”: a review of the literature and illustrative case report on second and third generation antiseizure medications and psychiatric effects

  • by Stefanie Nguyen, Thomas C. Varkey, Briana Khan, M. Christian Cornelius

  • June 1, 2026

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