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Spotlight on perampanel in the management of seizures: design, development and an update on place in therapy

Authors Faulkner MA

Received 20 July 2017

Accepted for publication 18 September 2017

Published 4 October 2017 Volume 2017:11 Pages 2921—2930

DOI https://doi.org/10.2147/DDDT.S122404

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Qiongyu Guo

Michele A Faulkner1,2

1Department of Pharmacy Practice, 2Department of Neurology, Creighton University Schools of Pharmacy and Medicine, Omaha, NE, USA


Purpose: Perampanel is a first-in-class antiepileptic medication approved for the treatment of partial (focal) seizures, and as adjunctive treatment for primarily generalized tonic–clonic seizures. The pharmacology, efficacy data, adverse-effect profile, pharmacokinetics and place in therapy are reviewed.
Summary: Perampanel is indicated for use in patients with epilepsy who are 12 years of age or older. It is the first medication designed specifically to be a non-competitive antagonist at post-synaptic α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate receptors. Efficacy in refractory seizures has been established, and ongoing efficacy demonstrated by post-marketing data. The drug is completely absorbed, and exhibits a half-life that allows for once-daily administration in doses up to 12 mg/day. Drug interactions are minimal, but increased doses may be necessary when given with strong inducers of cytochrome P450 enzymes, including when perampanel is co-administered with other antiepileptics that exhibit this property. The most common adverse effects noted in both clinical trials and post-marketing are dizziness and somnolence. Psychiatric and behavioral adverse events have been documented in both adult and pediatric patients, including those with no corresponding diagnostic history.
Conclusion: Perampanel is a novel adjunctive antiepileptic medication that is an effective option for adolescents and adults with partial seizures, and primarily generalized tonic–clonic seizures uncontrolled with other medications.

Keywords: perampanel, fycompa, focal seizures, partial seizures, generalized seizures

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