Fycompa (perampanel) / Eisai, Grupo Biotoscana, Catalyst Pharma - LARVOL DELTA

Severe Refractory NORSE with Bilateral Thalamostriatal Involvement: Anakinra Rescue After Multidrug Failure (ACTRIMS Forum 2026) - "Extensive infectious, autoimmune, and paraneoplastic evaluation was only positive for norovirus on stool PCR.Despite multiple antiseizure medications (levetiracetam, lacosamide, valproate, phenobarbital, clobazam, rufinamide, perampanel, topiramate, ketamine) plus IVIG, high-dose corticosteroids, and tocilizumab, GPDs persisted and the patient remained critically ill. Cytokine-directed therapy, particularly anakinra, may be effective in cryptogenic NORSE unresponsive to conventional antiseizure and first-line immunotherapies. Early recognition and targeted immunomodulation can improve outcomes in severe, refractory cases."

CNS Disorders • Epilepsy • Immunology • Musculoskeletal Pain

Comparative Effectiveness of Brivaracetam, Cenobamate, Lacosamide, and Perampanel in Focal Epilepsy. (PubMed, JAMA Neurol) - "Cenobamate was associated with a higher likelihood of treatment retention at 12 months compared with brivaracetam (OR, 0.43; 95% CI, 0.26-0.69; P < .001) and perampanel (OR, 0.56; 95% CI, 0.32-0.99; P = .047), with no significant difference vs lacosamide (OR, 0.81; 95% CI, 0.41-1.59; P = .53). These study findings suggest superior effectiveness of cenobamate over brivaracetam, lacosamide, and perampanel in adults with drug-resistant focal epilepsy in a large real-world setting."

Clinical • HEOR • Journal • CNS Disorders • Epilepsy

Pharmacokinetics of Perampanel in Danish Paediatric Patients With Epilepsy Based on Therapeutic Drug Monitoring. (PubMed, Basic Clin Pharmacol Toxicol) - "TDM is valuable for detecting under- or over-dosing caused by age-related clearance changes or enzyme-inducing co-medications. While dose adjustments can be guided by serum concentrations, optimization should ultimately target clinical seizure reduction and tolerability."

Journal • PK/PD data • Retrospective data • CNS Disorders • Epilepsy • Pediatrics

Pharmacological strategies for preventing post-stroke seizures and epilepsy. (PubMed, Front Neurol) - "Although current evidence is limited, we suggest that levetiracetam and lamotrigine may be preferred agents for preventing acute seizure recurrence. Statins, GLP-1 agonists, eslicarbazepine, perampanel, and losartan have not been evaluated yet and need further study on their ability to prevent first-time seizures in stroke patients. While clinical trials of antiseizure medications can be costly, further research into biomarkers of epileptogenesis could facilitate more feasible clinical trials to enhance the evidence base for antiseizure medications in post-stroke seizures and epilepsy."

Journal • Review • Cardiovascular • CNS Disorders • Epilepsy

Neuron-Glioma Synapses in Tumor Progression. (PubMed, Biomedicines) - "High functional connectivity within gliomas correlates with shorter patient survival. Therapies such as AMPA receptor antagonists (perampanel), glutamate release modulators (riluzole or sulfasalazine), and chloride cotransporter inhibitors (NKCC1 blockers) aim to improve outcomes for patients."

Journal • Review • Brain Cancer • Cognitive Disorders • Diffuse Midline Glioma • Epilepsy • Glioma • High Grade Glioma • Oncology • Solid Tumor

Placental transfer of third-generation antiepileptic drugs: in vivo lacosamide case study and in vitro investigation of transporter inhibition by lacosamide and perampanel. (PubMed, J Pharm Health Care Sci) - No abstract available

Journal • Preclinical

Pharmacovigilance signal detection of psychiatric adverse events induced by third-generation antiepileptic drugs in children. (PubMed, Front Pharmacol) - "Reports involving patients under 18 years old were retrieved using the generic and brand names of four drugs: lacosamide, perampanel, brivaracetam, and eslicarbazepine. The findings of this study provide a reference for clinical selection of third-generation AEDs. When initiating treatment in children, clinicians should consider the differential psychiatric risk profiles of these third-generation AEDs, monitor potential psychiatric side effects and adjust prescriptions promptly."

Adverse events • Journal • CNS Disorders • Psychiatry • Suicidal Ideation

Update on Medical Treatments for Essential Tremor: An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review. (PubMed, Mov Disord) - "Current evidence from RCTs with at least 1 month of follow-up is insufficient to confidently support the efficacy of available medical treatments for ET. There is a need for longer, higher-quality clinical trials to improve treatment recommendations and guide decision-making for clinicians and patients with ET."

Journal • Review • CNS Disorders • Essential Tremor • Movement Disorders • Parkinson's Disease

Seizure medications and interictal spiking: Implications for cognition and behavior. (PubMed, Epilepsia) - "The use of sodium channel blockers, such as lamotrigine and oxcarbazepine, produces cognitive improvements. Additionally, γ-aminobutyric acidergic agents, including clobazam and diazepam, are effective in treating developmental epileptic encephalopathies. Emerging therapies, including cannabidiol and perampanel, show promising IED and behavioral outcomes...Targeted reduction of IEDs may lead to improved cognitive and behavioral outcomes. This can be achieved by testing and recognizing ASMs in carefully designed prospective trials in animals and humans."

Journal • Review • CNS Disorders • Epilepsy

Exploring the Antiamoebic Potential of Zonisamide and Perampanel against Naegleria fowleri: Insights from In Vitro and Docking Studies. (PubMed, ACS Omega) - "These findings support their candidacy for further development as PAM therapeutics. Beyond the scientific results, the approach aligns with Sustainable Development Goal 3 (Good Health and Well-being) by promoting innovative, accessible treatment strategies for neglected diseases and with SDG 9 (industry, innovation, and infrastructure) through the use of computational drug repurposing technologies."

Journal • Preclinical • CTSB

Sleep effects in drug-resistant epileptic patients taking perampanel: an observational study. (PubMed, Neurol Sci) - "PER appears to preserve sleep quality and mildly improve quality of life. Furthermore, PER shows greater efficacy when used as a first add-on therapy in drug-resistant epilepsy."

Journal • Observational data • CNS Disorders • Epilepsy

Cognitive effects of perampanel assessed by the EpiTrack Junior Test in school-aged children with epilepsy (PubMed, Zh Nevrol Psikhiatr Im S S Korsakova) - "Adjunctive perampanel improves executive functions and is well tolerated in school-aged children with epilepsy."

Journal • Retrospective data • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy

Targeting Glutamate Receptors with IEM-1925: A Strategy Against Soman-Induced Status Epilepticus and Neurodegeneration. (PubMed, Neurotoxicology) - "Existing antiseizure medications (e.g., diazepam, DZP) often demonstrate insufficient efficacy...After 5min of subcutaneous exposure to 110μg/kg soman, which induced SE, rats received intraperitoneal injections (10mg/kg) of perampanel (PER), fanapanel (FNP), IEM-1925 (IEM), or DZP...Behavioral tests (open field, novel object recognition, and Y maze) confirmed IEM outperformed DZP and the solvent-treated group in ameliorating soman-induced anxiety, cognitive dysfunction, and memory impairment. In conclusion, IEM demonstrates potent triple effects-antiseizure, neuroprotective, and cognitive improving in soman exposure model, providing a novel therapeutic strategy and candidate drug for the medical treatment of OPNAs poisoning."

Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy • Mood Disorders • Psychiatry • Vascular Neurology

Perampanel Blocks Transsynaptic α-Synuclein Propagation and Neurodegeneration in a Mouse Model of Lewy Body Disease. (PubMed, Mov Disord) - "Perampanel could be a disease-modifying drug for Lewy body disease that modulates transsynaptic α-synuclein propagation, presumably by suppressing dynamin-dependent endocytosis."

Journal • Preclinical • CNS Disorders • Lewy Body Disease • Movement Disorders • Parkinson's Disease • SNCA

Persons with epilepsy have an elevated radiosensitivity, which may be mitigated by folic acid. (PubMed, J Neurol) - "PWE were clearly increased radiosensitive compared to healthy individuals and oncological patients. Male PWEs were found to be more sensitive than female PWEs. This may be due to their higher intake of folic acid, a substance which can protect against radiation."

Journal • Breast Cancer • CNS Disorders • Epilepsy • Oncology • Solid Tumor

Bayesian-Based Pharmacokinetic Framework Integrated with Therapeutic Drug Monitoring for Assessing Adherence to Antiseizure Medications: A Clinical Trial Simulation Study. (PubMed, J Med Internet Res) - "This study proposed an innovative Bayesian-based pharmacokinetic (PK) framework integrated with TDM data to address the above limitations, with a focus on 14 widely prescribed ASMs, including brivaracetam, carbamazepine, clobazam, eslicarbazepine acetate, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, phenobarbital, topiramate, valproic acid, vigabatrin, and zonisamide. This study establishes a Bayesian-based PK approach to enhance the assessment of ASMs adherence. This approach facilitates a paradigm shift from population-based management to patient-specific adherence profiling, offering a practical methodology for the precise evaluation of medication-taking behaviors."

Journal • PK/PD data • CNS Disorders • Epilepsy

Prescribed Drugs and Interpersonal Violence: A Case-Non-Case Study in the Spanish Pharmacovigilance Database. (PubMed, Pharmaceuticals (Basel)) - "Mostly drugs reported were montelukast, levetiracetam, bupropion, donepezil, perampanel, quetiapine, fluoxetine, and lorazepam. A statistically significant association/disproportion in the notification has been found in the reporting of interpersonal violence and different drugs according to the literature, notably atomoxetine, perampanel, memantine, donepezil, montelukast and methylphenidate. The results highlight that interpersonal violence, while rare, could occur as a clinically relevant adverse reaction to a small subset of medications. They underscore the importance of careful prescribing, especially in vulnerable populations and in individuals with a history of psychiatric disorders."

Adverse events • Journal • CNS Disorders • Mental Retardation • Psychiatry

Comparison of the effectiveness, safety and tolerability of Perampanel and Levetiracetam as monotherapy in Chinese patients with focal-onset seizures: A single-center, ambispective, open-label, real-world observational study. (PubMed, Epilepsia Open) - "This study compared the effectiveness and safety of PER and LEV as monotherapy in Chinese patients with focal-onset seizures (FOS), in which 70 patients receiving PER monotherapy and 77 patients receiving LEV monotherapy were enrolled. Compared with LEV, PER had significantly higher seizure-freedom rates (SFRs) at 6 and 12 months and a non-significant trend of higher SFR at 24 months. The two treatments had comparable retention rates. Chinese patients with FOS receiving PER monotherapy were more likely to achieve seizure freedom and had a higher incidence of dizziness than LEV."

Journal • Monotherapy • Observational data • Real-world evidence • CNS Disorders • Epilepsy

Psychiatric and behavioural side effects of antiseizure medications in epilepsy. (PubMed, J Neurol) - "PBSEs can often be anticipated, mitigated, and frequently reversed. A risk-stratified prescribing strategy-monotherapy first, enzyme-neutral or mood-friendly medications for vulnerable patients, folate supplementation for inducers, and early switch from offending agents-can safeguard mental health without compromising seizure control."

Adverse events • Journal • Review • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • Psychiatry

Economic Evaluation of Therapeutic Drug Monitoring and Precision Dosing in Pediatrics: A Short Communication. (PubMed, Ther Drug Monit) - "The lack of standardized methodologies and economic endpoints, along with potential underreporting of negative findings, restricts the generalizability of conclusions. Nevertheless, current evidence supports TDM-MIPD as a potentially cost-effective approach in pediatric pharmacotherapy."

HEOR • Journal • Pediatrics

SENIPERA: Senicapoc and Perampanel for Newly Diagnosed Glioblastoma (clinicaltrials.gov) - P1 | N=36 | Not yet recruiting | Sponsor: Aarhus University Hospital

New P1 trial • Brain Cancer • Glioblastoma • Oncology • Solid Tumor

Amp Up the Dose: Perampanel Loading Strategies in Refractory and Super Refractory Status Epilepticus (ASHP 2025) - "Learning Objectives: Describe perampanel pharmacokinetics and available literature supporting higher dosing strategies used in status epilepticus."

Epilepsy

Expanding the toolkit: An update on the evolution of new therapies for Lennox-Gastaut Syndrome. (PubMed, Semin Pediatr Neurol) - "The purpose of this paper is to address three such aspects of treatment evolution for LGS: (1) To review data supporting the repurposing of existing drugs for use in LGS, specifically, perampanel and cenobamate. (2) To present recent (soticlestat), ongoing (carisbamate, bexicaserin, clemizole) and upcoming (opakalim) clinical drug trials for LGS...With the richness of recent trial development for LGS combined with the nascence of clinical trials for specific genetic epilepsies comes a new era in which treatment options for LGS will continue to expand. Increasing understanding of the underlying genetic and molecular underpinnings of LGS should enable development of unique therapies, with the continued aims of sustained, durable seizure control and additional positive impact on central nervous system outcomes and beyond."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy

Association of Aggression and Anti-seizure Medications in Pediatric Patients: Disproportionality Analysis Using the FDA Adverse Event Reporting System. (PubMed, Eur J Pharmacol) - "Signals of aggression related to different ASMs were identified. Significantly strong signals were observed for perampanel, levetiracetam and brivaracetam. Compared to infants and preschooler, ASMs-associated aggression is more common in school children and teenagers."

Adverse events • Journal • CNS Disorders • Epilepsy • Pediatrics

Treatment approaches in posthypoxic myoclonus: A narrative review with expert opinion. (PubMed, Epilepsia) - "Treatment remains largely empirical and variable, with benzodiazepines and antiseizure medications (e.g., levetiracetam, valproate, clonazepam, perampanel) being commonly used. Acute PHM is a clinically heterogeneous disorder with significant diagnostic and therapeutic challenges. Future research should focus on refining diagnostic criteria and identifying targeted therapies to improve outcomes in this often-fatal condition."

Journal • Review • Cardiovascular • CNS Disorders • Epilepsy • Movement Disorders