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Acta Neurol Scand. 2016 Nov;134(5):374-377. doi: 10.1111/ane.12558. Epub 2016 Jan 13.

Perampanel as add-on treatment in refractory focal epilepsy. The Dianalund experience.

Author information

1
Danish Epilepsy Center, Filadelfia, Dianalund, Denmark.
2
Danish Epilepsy Center, Filadelfia/University of Copenhagen, Dianlund, Denmark. guru@filadelfia.dk.
3
IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy. guru@filadelfia.dk.

Abstract

BACKGROUND:

Perampanel (PER) is an antagonist of AMPA receptors that has been approved for adjunctive treatment of partial-onset seizures.

AIMS:

To evaluate effectiveness and safety of PER as add-on treatment in patients with severely refractory focal epilepsy.

METHODS:

PER was introduced as add-on treatment in 22 consecutive patients with drug-resistant focal epilepsy. PER was started with 2 mg/day at bedtime and was up-titrated by 2 mg/day every 2-4 weeks.

RESULTS:

All patients suffered from severely refractory focal epilepsy (86% took 2 or more AEDs prior PER initiation; 40% had been submitted to surgery or were surgery candidates; 7 had VNS). After 12 months since PER initiation, the retention rate was 54.5% and the responder rate was 27.2%, including 9.1% seizure-free patients. Mean PER dose in the responders was 8 mg/day (range 4-10). Most common side effects were tiredness, behavioral changes (primarily aggressivity), dizziness and were reported in 59.1% of patients, leading to PER discontinuation in 31.8% of subjects.

CONCLUSIONS:

PER as add-on treatment can achieve clinically meaningful improvement in patients suffering from severely refractory focal epilepses. Further studies are warranted to explore the tolerability profile, with particular focus on psychiatric adverse events.

KEYWORDS:

drug-refractory focal epilepsy; efficacy; perampanel; psychiatric adverse events; safety; tolerability

PMID:
26763771
DOI:
10.1111/ane.12558
[Indexed for MEDLINE]

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