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Perampanel (PER), one of the newer antiepileptic drugs has a novel antiseizure mechanism acting as a non-competitive α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptor antagonist [1]. It was licensed as add-on medication for refractory focal-onset seizures after conduction of 3 phase III double-blinded randomized clinical trials [2–4] followed by an open label extension with a follow-up reaching 4 years [5]. The initial clinical trials had a 6 week titration period and a 13 week follow-up period and showed high retention rates varying from 75% to 92% on different doses [2–4].