Side Effects of perampanel: A Synthesis of Findings from 30 Studies

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Original Abstract of the Article

Major Research Findings

Perampanel is a new generation antiepileptic drug (AED) that is used to treat partial-onset seizures in adults and adolescents. It is also used in combination with other AEDs to treat a variety of epilepsy syndromes, including Lennox-Gastaut syndrome, juvenile myoclonic epilepsy, and Dravet syndrome. 20 、 23 、 13 、 1 、、 16 、 22 、 26 、 2

Reasons for Side Effects

Perampanel is a non-competitive antagonist of the AMPA receptor, a type of glutamate receptor that is involved in excitatory neurotransmission. By blocking the AMPA receptor, perampanel reduces the excitability of neurons and helps to prevent seizures. However, the AMPA receptor is also involved in many other important brain functions, such as learning, memory, and motor control. This is why perampanel can cause side effects such as drowsiness, dizziness, and aggression. 24

Common Side Effects

Drowsiness

The most common side effect of perampanel is drowsiness. 23 、 16 、 2

Dizziness

Perampanel can cause dizziness. 23 、 16

Aggression

Perampanel can cause aggression. 3 、 5 、 17

Irritability

Perampanel can cause irritability. 3 、 5 、 11 、 2

Psychiatric Disorders

Perampanel can cause psychiatric disorders such as depression and anxiety. 8 、 9 、 21

Cognitive Impairment

Perampanel can cause cognitive impairment such as memory and attention problems. 27 、 4

Countermeasures for Side Effects

Drowsiness

Drowsiness is the most common side effect of perampanel. Drowsiness is often more common when you first start taking perampanel and often subsides over time. Drowsiness may be reduced by changing the time of day you take perampanel to nighttime. 23 、 16 、 2

Dizziness

Perampanel can cause dizziness. Dizziness is often more common when you first start taking perampanel and often subsides over time. Dizziness may be reduced by changing the time of day you take perampanel to nighttime. 23 、 16

Aggression

Perampanel can cause aggression. Aggression is often more common when you first start taking perampanel and often subsides over time. Aggression may be reduced by lowering the dosage of perampanel. 3 、 5 、 17

Irritability

Perampanel can cause irritability. Irritability is often more common when you first start taking perampanel and often subsides over time. Irritability may be reduced by lowering the dosage of perampanel. 3 、 5 、 11 、 2

Psychiatric Disorders

Perampanel can cause psychiatric disorders such as depression and anxiety. Psychiatric disorders may be reduced by lowering the dosage of perampanel. 8 、 9 、 21

Cognitive Impairment

Perampanel can cause cognitive impairment such as memory and attention problems. Cognitive impairment may be reduced by lowering the dosage of perampanel. 27 、 4

Comparison between Studies

Commonalities of Studies

Many studies have shown that perampanel can cause side effects such as drowsiness and dizziness. 23 、 16 、 2

Differences between Studies

The frequency and severity of perampanel side effects vary from study to study. This is thought to be influenced by a variety of factors, such as the age of the study participants and the use of other drugs.

Precautions for Real-Life Applications

Perampanel is an effective drug for treating refractory epilepsy. However, because perampanel can cause side effects such as drowsiness and dizziness, it is necessary to refrain from driving or operating dangerous machinery. 23 、 16 、 2

Limitations of Current Research

Research on the side effects of perampanel is still insufficient. In particular, information on long-term side effects is limited. 30 、

Directions for Future Research

Research on the long-term side effects of perampanel needs to be conducted. Also, it is necessary to develop methods for reducing the side effects of perampanel. 30

Conclusion

Perampanel is an effective drug for treating refractory epilepsy, but it can cause side effects such as drowsiness and dizziness. When taking perampanel, be aware of the side effects and follow the doctor's instructions.

Literature analysis of 30 papers
Positive Content
22
Neutral Content
3
Negative Content
5
Article Type
0
1
0
5
30
1.

A pharmacovigilance study on antiepileptic medications in a paediatric hospital in Italy.

Author: Monti GuarnieriNicoletta, PompilioAdriana, MariniCarla, OrtenziGiovanni Battista, AndrescianiEmanuela, GarzoneAngela Maria Felicita, IeracitanoMaria Consuelo, PolidoriCarlo

ASM safety profile
Adverse drug reactions

Antiseizure medications (ASMs) are the standard treatment for epilepsy. This study created a database to assess the safety profile of ASMs used in a pediatric hospital and to document adverse drug reactions (ADRs).

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

Language : English

6.

Retention of perampanel in adults with pharmacoresistant epilepsy at a single tertiary care center.

Author: WehnerTim, MannanShahidul, TuragaSanchit, VallabhaneniKirtana, YipHao Meng, WiggansCarys, ShankarRohit, DuncanJohn S, SanderJosemir W

PER for epilepsy
CNS side effects
Mental health impact

This study describes the clinical experience with perampanel (PER) in a large UK tertiary epilepsy center. PER resulted in some benefit in 40% of those exposed, but adverse effects on mental health and balance were common.

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

8.

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

9.

Clinical experience with perampanel: focus on psychiatric adverse effects.

Author: CoyleHelen, CloughPeter, CooperPaul, MohanrajRajiv

Drug-refractory epilepsy treatment

Perampanel, a novel antiepileptic drug, demonstrated efficacy and tolerability in patients with drug-refractory epilepsy.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
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

10.

Perampanel in the general population and in people with intellectual disability: Differing responses.

Author: ShankarRohit, HenleyWilliam, WehnerTim, WiggansCarys, McLeanBrendan, PaceAdrian, MohanMonica, SadlerMartin, DoranZoe, HudsonSharon, AllardJon, SanderJosemir W

Psychiatric side effects

This study analyzed data from the UK Ep-ID Research Register to explore differences in response to Perampanel (PER) adjunctive treatment for refractory epilepsy between people with intellectual disability (ID) and the general population. The findings provide clinically useful information for prescribing PER in this population.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
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.

Language : English

13.

The adverse event profile of perampanel: meta-analysis of randomized controlled trials.

Author: ZaccaraG, GiovannelliF, CincottaM, VerrottiA, GrilloE

Ataxia
Dizziness
Irritability
Somnolence
Study withdrawal
Weight increase

Perampanel was significantly associated with an increased risk of adverse event-related study withdrawals at 4 mg/day and 12 mg/day. Vestibulocerebellar adverse events (dizziness, ataxia), sedative effects (somnolence), irritability and weight increase were significantly associated with perampanel treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Adjunctive perampanel in refractory epilepsy: Experience at tertiary epilepsy care center in Tours.

Author: MauroussetAude, LimousinNadège, PralineJulien, BiberonJulien, CorciaPhilippe, De ToffolBertrand

Seizure reduction
Psychiatric side effects

Perampanel (PER) was effective in reducing seizure frequency in patients with severe refractory epilepsy. It was similarly safe and effective in patients with learning disability or psychiatric comorbidity.

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

Language : English

17.

Verbal fluency functional magnetic resonance imaging detects anti-seizure effects and affective side effects of perampanel in people with focal epilepsy.

Author: XiaoFenglai, CaciagliLorenzo, WandschneiderBritta, FleuryMarine, BindingLawrence, GiampiccoloDavide, HillAndrea, GalovicMarian, FoongJaqueline, ZhouDong, SanderJosemir W, DuncanJohn S, KoeppMatthias J

Seizure control
Increased anger

This study used fMRI to investigate the brain regions associated with the therapeutic effects and side effects of perampanel, a medication for treating epilepsy. The results highlight the involvement of the thalamus and caudate in the beneficial effects of perampanel, while the orbitofrontal cortex (OFC) is implicated in the increased anger and aggression reported with this treatment.

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

20.

Update on Pharmacological Treatment of Progressive Myoclonus Epilepsies.

Author: FerlazzoEdoardo, TreniteDorothee Kasteleijn-Nolst, HaanGerrit-Jan de, Felix NitschkeFelix, AhonenSaija, GaspariniSara, MinassianBerge A

Progressive myoclonus epilepsies (PMEs) are a group of rare inherited conditions. This review discusses the current pharmacological treatments for PMEs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Efficacy and safety of adjunctive treatment with perampanel in epilepsy patients.

Author: LimK Y, KhooC S, RajahR, TanH J, TajurudinF W

Epilepsy treatment
High cost

Perampanel is an adjunctive therapy for both generalized and focal seizures and has been widely used in Western countries. However, its high cost limits its use in other regions.

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

Language : English

22.

Perampanel as adjunctive therapy in drug resistant epilepsy in adolescents and children waiting for epilepsy surgery: A multicenter observational study in Thailand.

Author: SuwanpakdeePiradee, SaksritaveeBurachat, LikasitthananonNapakjira, SimasathienThitiwan, DeesudchitTayard, KhongkhatithumChaiyos, ViravanSorawit, NabangchangCharcrin

Seizure control
Ataxia
Behavioral changes
Drowsiness

Perampanel (PER) was effective and well-tolerated for seizure control in pediatric and adolescent patients with drug-resistant epilepsy (DRE) in a real-world setting. In 85 patients, PER significantly reduced seizure frequency at all time points (p<0.001). At 180 days, 64.9% had ≥75% seizure reduction and 36.8% achieved seizure freedom. Common side effects included drowsiness, ataxia, and behavioral changes, which improved with dose reduction.

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.

Language : English

23.

First clinical experiences with perampanel--the Kork experience in 74 patients.

Author: SteinhoffBernhard J, BacherMatthias, BastThomas, KornmeierReinhold, KurthChristoph, SchollyJulia, StaackAnke M, WisniewskiIlona

Reduced seizure frequency
Seizure-free
Ataxia
Cognitive slowing
Depression
Dizziness
Falls
Irritability
Somnolence

Perampanel (PER) is a promising add-on treatment for difficult-to-treat epilepsies. In a study of 74 patients, 46% responded with at least a 50% reduction in seizure frequency. The most common side effects were somnolence (42%) and dizziness (18%).

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

Language : English

25.

An Italian multicentre study of perampanel in progressive myoclonus epilepsies.

Author: CanafogliaLaura, BarbellaGiuseppina, FerlazzoEdoardo, StrianoPasquale, MagauddaAdriana, d'OrsiGiuseppe, MartinoTommaso, AvolioCarlo, AgugliaUmberto, SueriChiara, GiulianoLoretta, SofiaVito, ZibordiFederica, RagonaFrancesca, FreriElena, CostaCinzia, Nardi CesariniElena, FanellaMartina, Rossi SebastianoDavide, RiguzziPatrizia, GambardellaAntonio, Di BonaventuraCarlo, MichelucciRoberto, GranataTiziana, BisulliFrancesca, LicchettaLaura, TinuperPaolo, BeccariaFrancesca, VisaniElisa, FranceschettiSilvana

Myoclonus reduction
PME treatment
Seizure reduction
Drowsiness
Irritability
Psychiatric side effects

Perampanel (PER) effectively reduced myoclonus severity and seizure frequency in patients with progressive myoclonus epilepsy (PME). In a study of 49 patients, PER reduced myoclonus severity by 50% and decreased seizure frequency in 17 patients. However, 44.8% of patients experienced side effects, most commonly irritability and drowsiness. PER appears to be a promising treatment option for PME but careful monitoring is necessary.

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

Language : English

28.

Mining and analysis of adverse drug reactions associated with perampanel based on FAERS database.

Author: LiuPengcheng, ZhangYuwei, XuXiaoli, ZhouMing, FeiYi, ZhangLiming

Anti-seizure effect
Adverse events
Safety concerns

This study aims to assess the safety of Perampanel (PER) using data from the FDA's Adverse Event Reporting System (FAERS) database. The study investigates the safety of PER, a non-competitive AMPA glutamate receptor antagonist used as an anti-seizure medication, by analyzing a large database of adverse events.

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

29.

A Narrative Review of the Lesser Known Medications for Treatment of Restless Legs Syndrome and Pathogenetic Implications for Their Use.

Author: YehPaul G, SpruytKaren, DelRossoLourdes M, WaltersArthur S

RLS treatment
Incomplete response
Side effects

This review explores various treatment options for Restless Legs Syndrome (RLS), including dopamine agonists, anticonvulsants, iron supplementation, opioids, and benzodiazepines. It also highlights the limitations of these treatments and emphasizes the importance of considering other treatment options in clinical practice.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

30.

The long-term safety of antiepileptic drugs.

Author: GaitatzisAthanasios, SanderJosemir W

Epilepsy treatment
Adverse effects
Neurodevelopmental effects
Teratogenic effects

Antiepileptic drugs (AEDs) are associated with adverse effects that can impact treatment tolerability and success. Physicians should be aware of the late and chronic AEs of AEDs and systematically screen for them.

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.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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