Effects of perampanel: A Synthesis of Findings from 19 Studies

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Original Abstract of the Article

Major Research Findings

Perampanel is a newly licensed antiepileptic medication for the adjunctive treatment of patients (age 12 and older) with partial epilepsy with or without secondary generalization. 9 Perampanel appears to be associated with a relatively low incidence of serious adverse effects, particularly at low doses. 9 However, there is a greater rate of psychiatric side effects in patients treated with perampanel, principally, irritability and aggression, than with placebo. 9 Perampanel is a noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor antagonist, which is used clinically for the treatment of partially refractory epilepsy. 17 Perampanel was found to be effective in reducing seizure frequency in mice with temporal lobe epilepsy. 17 Perampanel also has pain attenuating potential in chronic constriction injury-induced neuropathic pain in rats. 16 Perampanel may have a positive effect on cognition in adult patients with epilepsy. 4 Perampanel demonstrated an antitumor effect in malignant glioma cells. 11 The antiepileptic drug perampanel may also have an antitumor effect through the induction of apoptosis. 11 Perampanel appears to be neuroprotective against post-SAH early brain injury through the anti-inflammatory and anti-apoptotic effects. 8

Benefits and Risks

Benefit Summary

Perampanel may be effective in reducing seizure frequency in patients with partial epilepsy. 9 Perampanel has been shown to improve cognitive function in some patients with epilepsy. 4 Perampanel may have a pain-reducing effect in patients with neuropathic pain. 16 Perampanel may be effective in treating brain tumors. 11 Perampanel may protect against brain injury after subarachnoid hemorrhage. 8

Risk Summary

Common side effects of perampanel include dizziness, somnolence, fatigue, irritability, nausea, and falls. 9 Perampanel can also cause psychiatric side effects, such as depression and aggression. 9 These effects are more likely to occur at higher doses. 9 The risk of serious psychiatric side effects is low. 9

Comparison of Studies

Commonalities of Studies

Multiple studies suggest that perampanel may be effective in the treatment of partial epilepsy. 9 、 17 、 16 The studies also suggest that perampanel can cause side effects, including dizziness, drowsiness, fatigue, irritability, nausea, and falls. 9 Perampanel may also cause psychiatric side effects, such as depression and aggression. 9 、 19

Differences of Studies

The incidence of side effects may vary depending on the study. 9 、 19 The impact of perampanel on cognitive function may also vary. 4 、 Perampanel may improve cognitive function in some patients while worsening it in others. 4 、

Consistency and Contradictions of Results

There are multiple research findings suggesting that perampanel may be effective in the treatment of partial epilepsy. 9 、 17 、 16 However, perampanel can cause side effects, including dizziness, drowsiness, fatigue, irritability, nausea, and falls. 9 Notably, higher doses may be more likely to lead to psychiatric side effects, such as depression and aggression. 9 、 19 While side effects are generally mild to moderate, serious side effects may occur in some patients. 9

Notes on Application to Real Life

Perampanel may be an effective treatment for partial epilepsy, but the risk of side effects must be considered. 9 、 17 、 16 Higher doses are more likely to cause psychiatric side effects, such as depression and aggression. 9 、 19 If you are taking perampanel, follow your doctor's instructions carefully and seek immediate medical attention if you experience any side effects. 9 、 19

Limitations of Current Research

Research on perampanel is still ongoing and not fully comprehensive. 9 、 17 、 16 Specifically, the long-term effects of perampanel are not yet fully understood. 9 、 17 、 16 Future research should investigate the long-term effects of perampanel in greater detail. 9 、 17 、 16

Directions for Future Research

Research is needed to investigate the long-term effects of perampanel. 9 、 17 、 16 Additional research is also necessary to find ways to minimize the side effects of perampanel. 9 、 19

Conclusion

Perampanel may be an effective treatment for partial epilepsy, but it's important to consider the risk of side effects. 9 、 17 、 16 Follow your doctor's instructions carefully, and seek immediate medical attention if you experience any side effects. 9 、 19 Future research is needed to better understand the long-term effects of perampanel. 9 、 17 、 16

Literature analysis of 19 papers
Positive Content
15
Neutral Content
1
Negative Content
3
Article Type
2
0
0
1
19
1.

Cognitive effects of adjunctive perampanel for partial-onset seizures: A randomized trial.

Author: MeadorKimford J, YangHaichen, Piña-GarzaJesus Eric, LaurenzaAntonio, KumarDinesh, WesnesKeith A

Improved episodic memory
Dizziness
Reduced attention
Reduced memory speed
Somnolence

Perampanel did not improve global cognitive function in adolescents with partial-onset seizures, but it did improve some cognitive subdomains while worsening others.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Effects of low-dose titration on the tolerability and safety of perampanel.

Author: YamamotoYoshiaki, ShirataniYuka, NishidaTakuji, UsuiNaotaka, ImaiKatsumi, KagawaYoshiyuki, TakahashiYukitoshi

Reduced adverse events

Low-dose titration of perampanel significantly decreased the incidence of adverse events in patients, especially those not taking enzyme-inducing antiseizure medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Plasma concentration and clinical effects of perampanel-The Kork experience.

Author: SteinhoffBernhard J, HübersElisabeth, KurthChristoph, Jürges Kehl-KorkUta

Reduced seizures
Tolerability issues

This study investigated the correlation between steady-state plasma concentrations of perampanel and efficacy and tolerability in adult patients with difficult-to-treat epilepsy. While a close linear correlation was observed between PER dose and plasma concentration, there was no statistically significant difference in plasma levels between responders and non-responders. This suggests that a reliable therapeutic range for PER plasma concentrations may not exist.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

4.

Effects of perampanel on cognition and quantitative electroencephalography in patients with epilepsy.

Author: AhnSeon-Jae, KimTae-Joon, ChaKwang Su, JunJin-Sun, ByunJung-Ick, ShinYong-Won, SunwooJun-Sang, LeeSeungHwan, YuKyung-Sang, JangIn-Jin, ChuKon, LeeSang Kun, JungKi-Young

Cognitive improvement
EEG slowing

Perampanel, an antiepileptic drug, showed improvements in delayed recall of the Rey Complex Figure in patients with epilepsy but did not affect other cognitive function tests. It also induced electrophysiological slowing, which correlated with the drug level in blood.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Effects of the noncompetitive AMPA receptor antagonist perampanel on thalamo-cortical excitability: A study of high-frequency oscillations in somatosensory evoked potentials.

Author: LanzoneJacopo, BoscarinoMarilisa, RicciLorenzo, InsolaAngelo, TombiniMario, Di LazzaroVincenzo, AssenzaGiovanni

PER efficacy

This longitudinal cohort study aimed to assess the effect of Perampanel (PER) on cortico-subcortical networks in people with epilepsy using high-frequency oscillations of somatosensory evoked potentials (SEP-HFOs).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

The Novel Direct Modulatory Effects of Perampanel, an Antagonist of AMPA Receptors, on Voltage-Gated Sodium and M-type Potassium Currents.

Author: LaiMing-Chi, TzengRay-Chang, HuangChin-Wei, WuSheng-Nan

Epilepsy treatment
Motor neuron disease treatment
None

This study investigated the effects of perampanel (PER) on ionic currents in different types of cells, finding that PER differentially and effectively suppressed both voltage-gated Na+ currents (I_Na) and M-type K+ currents (I_K(M)).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Perampanel tolerability in children and adolescents with focal epilepsy: Effects on behavior and executive functions.

Author: OpertoFrancesca Felicia, PastorinoGrazia Maria Giovanna, MazzaRoberta, Di BonaventuraCarlo, MatricardiSara, VerrottiAlberto, CarotenutoMarco, ViggianoAndrea, CoppolaGiangennaro, EliaMaurizio

Effective treatment
Well-tolerated

Perampanel (PER), a non-competitive AMPA glutamate receptor antagonist, has been approved for focal and generalized epilepsies. While PER is generally well-tolerated and effective in treating pediatric epilepsy syndromes, its effect on executive functions needs further investigation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

11.

Anti-tumor effects of perampanel in malignant glioma cells.

Author: TatsuokaJuri, SanoEmiko, HanashimaYuya, YagiChihiro, YamamuroShun, SumiKoichiro, HaraHiroyuki, TakadaKazuhide, KanemaruKazunori, Komine-AizawaShihoko, KatayamaYoichi, YoshinoAtsuo

Antitumor effect
Apoptosis induction
Glioblastoma treatment
Perampanel resistance
SERPINE1 overexpression

This study investigates the potential antitumor effects of perampanel, an antiepileptic drug, in malignant glioma cell lines. Perampanel demonstrated a dose-dependent inhibitory effect on cell viability and showed further antitumor effects when combined with temozolomide. The study also suggests that SERPINE1 expression may be involved in perampanel susceptibility.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Long-term effects of adjunctive perampanel on cognition in adolescents with partial seizures.

Author: Piña-GarzaJesus E, LagaeLieven, VillanuevaVicente, RenfroeJ Ben, LaurenzaAntonio, WilliamsBetsy, KumarDinesh, MeadorKimford J

No growth effects
Seizure control
Dizziness
Somnolence

Long-term adjunctive treatment with perampanel did not have any significant overall effects on cognition in adolescents with inadequately controlled partial seizures. Perampanel showed sustained long-term seizure control and had a safety and tolerability profile similar to that observed in prior clinical studies.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

HLAs associated with perampanel-induced psychiatric adverse effects in a Korean population.

Author: JangYoonhyuk, KimTae-Joon, MoonJangsup, YangTae-Won, KimKeun Tae, ParkByeong-Su, LimJung-Ah, JunJin-Sun, LeeSoon-Tae, JungKeun-Hwa, ParkKyung-Il, JungKi-Young, ChuKon, LeeSang Kun

Psychiatric adverse effects

Specific HLA alleles were found to be associated with the development of psychiatric adverse effects in patients taking perampanel, a new-generation antiepileptic drug.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Neuropathic pain attenuating effects of perampanel in an experimental model of chronic constriction injury in rats.

Author: KhanguraRavneet Kaur, BaliAnjana, KaurGunjanpreet, SinghNirmal, JaggiAmteshwar Singh

Neuropathic pain treatment

Perampanel, an AMPA receptor antagonist, reduced neuropathic pain in rats. The pain-attenuating effect of perampanel was significantly reduced by naloxone, suggesting that the opioid system plays a role in perampanel's mechanism of action.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Relationship between plasma concentrations and clinical effects of perampanel: A prospective observational study.

Author: ContinManuela, PondrelliFederica, MuccioliLorenzo, MohamedSusan, SantucciMargherita, FerriLorenzo, LicchettaLaura, TinuperPaolo, BisulliFrancesca,

Seizure control
Behavioral changes
Dizziness

No significant correlation was found between perampanel (PMP) plasma concentrations and both tolerability and seizure control in patients with epilepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Psychiatric and Behavioural Side Effects Associated With Perampanel in Patients With Temporal Lobe Epilepsy. A Real-World Experience.

Author: MammìAnna, FerlazzoEdoardo, GaspariniSara, BovaValentina, NeriSabrina, LabateAngelo, MastroianniGiovanni, BiancoConcetta Lo, CianciVittoria, AgugliaUmberto

psychiatric side effects

Perampanel, an anti-seizure medication, was studied in patients with focal epilepsy. There was no significant difference in incidence and severity of psychiatric and behavioral side effects between patients with temporal lobe epilepsy and those with other focal epilepsies. The most common side effects were irritability and aggression.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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