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

Effect of early tolerability and co-medication on long-term perampanel treatment outcomes in real-world settings. (PubMed, Clin Neurol Neurosurg) - "In this real-world study, the first 3 months after perampanel initiation represent a critical period for optimising retention and seizure control through adverse event management. Concomitant use of EIASM, may be associated with difference in efficacy. Early monitoring of adverse events and appropriate consideration of concomitant ASMs may optimise long-term perampanel treatment outcomes."

Journal • Real-world evidence • CNS Disorders • Epilepsy

Treatment Continuation and Long-Term Outcomes of Perampanel in Primary Orthostatic Tremor; A Cohort Study. (PubMed, Mov Disord Clin Pract) - "In around half of patients, continued use of perampanel is associated with better clinical outcomes, also on the long term, but adverse effects are common and persistent."

Journal • CNS Disorders • Depression • Mood Disorders • Movement Disorders • Pain • Psychiatry

Effectiveness of low-dose perampanel in focal epilepsy patients aged twelve or older in Southern China: an observational study. (PubMed, Sci Rep) - No abstract available

Journal • Observational data • CNS Disorders • Epilepsy

How could perampanel, a potent AMPAergic antagonist, inhibit seizures but largely spare normal neurotransmission? (PubMed, Br J Pharmacol) - "AMPAR activation constitutes two sequential processes, namely the association (glutamate binding) and the transformation (protein conformational change) steps. Perampanel slows transformation, resulting in glutamate-dependent bidirectional effects. In seizures and high ambient glutamate, the association steps are so fast that the transformation steps are relatively rate-limiting in AMPAR activation. However, a synchronisation effect of perampanel may emerge in low and variable glutamate (by shifting the rate-limiting role to the slowed and more uniform transformation steps). Perampanel can therefore selectively inhibit ictal discharges, but may also contribute to inadvertent seizure aggravation or psychiatric events with the potential synchronisation effect. The latter can be managed by deliberate and delicate up-or-down titration of the perampanel clinical dosage."

Journal • CNS Disorders • Epilepsy • Psychiatry

Modulation of glutamate metabolism in Niemann-pick disease type C1 mice. (PubMed, Mol Genet Metab Rep) - "Previous work has implicated dysregulation of glutamate signaling as a potential pathogenic mechanism. In this study, we explore the efficacy of AMPA receptor inhibition and the role of SLC1A6, a Purkinje neuron glutamate transporter, in NPC1 cerebellar pathology."

Journal • Preclinical • Frontotemporal Lobar Degeneration • Genetic Disorders • Lysosomal Storage Diseases • Metabolic Disorders • Rare Diseases

Early Cenobamate as a Third-Line Option in Drug-Resistant Focal Epilepsy: A Paradigm Shift? (PubMed, Neurol Ther) - "In this real-world study, early third-line CNB exhibits potentially favorable effectiveness compared with other commonly used third-line ASMs, and tolerability remained acceptable. These findings support the need for larger prospective studies to better define optimal treatment sequencing in focal-onset DRE."

Journal • CNS Disorders • Epilepsy

Effectiveness and safety of perampanel in patients with lennox-gastaut syndrome: a single-arm meta-analysis with meta-regression and sensitivity analyses. (PubMed, Epilepsy Behav) - "Perampanel demonstrates clinically meaningful seizure reduction in LGS with modest seizure-freedom and a behaviorally skewed safety profile. Despite heterogeneity and mostly retrospective data, findings support adjunctive use and highlight the need for larger, high-quality RCTs."

Journal • Retrospective data • Review • CNS Disorders • Epilepsy • Psychiatry

Progressive Myoclonic Epilepsies - A Pragmatic Review. (PubMed, Neurol India) - "This review explores the clinical features and genetic factors associated with the more prevalent as well as recently described forms of PME for effective clinical evaluation, and suggests management strategies for this challenging condition."

Journal • Review • Alzheimer's Disease • Ataxia • CNS Disorders • Cognitive Disorders • Epilepsy • Metabolic Disorders • Movement Disorders

Mortality Risk After Initiation of Cenobamate or Other Antiseizure Medications (AAN 2026) - "Objective: To retrospectively examine all-cause mortality in patients after initiating cenobamate vs mortality in patients treated with selected antiseizure medications (ASMs) that have similar patterns of use in medication-resistant epilepsy.Background: A previous post-hoc analysis of survival in a clinical trial cohort showed that the all-cause standardized mortality ratio (SMR) for cenobamate-treated patients was 1.32 (95% CI: 0.84-2.0), which was not significantly different from the general population.Design/ De-identified electronic health records from the Truveta database identified adults (≥18 years) with an epilepsy diagnosis who initiated therapeutic doses of cenobamate or another selected ASM (brivaracetam, clobazam, lacosamide, eslicarbazepine, or perampanel) between 1/1/2020-12/5/2024. Patients treated with cenobamate at therapeutic doses had lower mortality rates than patients treated with selected comparable ASM."

CNS Disorders • Epilepsy

Epilepsy-related and All-cause Healthcare Resource Utilization After Initiation of Adjunctive Cenobamate (AAN 2026) - "Objective: To evaluate the comparative effect of initiating cenobamate vs selected antiseizure medications (ASMs, brivaracetam, clobazam, eslicarbazepine, lacosamide, or perampanel) on epilepsy-related and all-cause inpatient (IP) and emergency room (ER) utilization rates.Background: Cenobamate is an ASM approved for adults in the US that has demonstrated efficacy across focal seizure subtypes.Design/ A retrospective observational study using de-identified electronic health records from the Truveta database identified adults (≥18 years) with an epilepsy diagnosis who initiated cenobamate or another selected ASM between 1/1/202012/52024. Initiating cenobamate was associated with a significant reduction in both epilepsy-related and all-cause IP admissions and ER visits compared to propensity-matched patients who similarly could have initiated cenobamate but instead initiated other ASMs."

HEOR • CNS Disorders • Epilepsy

Refractory Autoimmune Encephalitis with Focal Status Epilepticus in a Patient with KLHL11 Antibody Syndrome (AAN 2026) - " The patient was found to have electroclinical seizures with focal status epilepticus despite extensive anti-seizure medication (ASM) therapy, including brivaracetam, lacosamide, valproic acid, phenobarbital, cenobamate, perampanel, and clobazam. This case illustrates the recurrent and refractory nature of KLHL11 antibody-associated autoimmune encephalitis, particularly when complicated by drug-resistant epilepsy. Early recognition of recurrence and escalation of immunotherapy, including rituximab, may be necessary in managing such cases. Comprehensive neurologic, immunologic, and oncologic evaluations are essential to guide ongoing therapy and improve clinical outcomes."

Clinical • CNS Disorders • Epilepsy • Germ Cell Tumors • Immunology

Perampanel Utilization in Management of Status Epilepticus in the Neuro-ICU: A Single-center Retrospective Experience (AAN 2026) - "In refractory and super-refractory SE, perampanel was found to play one or more significant roles; it was highly effective as add-on therapy, had moderate but practically useful utility in weaning off anesthetics, showed some effectiveness in late SE termination, but was unsuccessful in preventing intubation in the two cases of non-convulsive SE. These data highlight the need for prospective studies on larger number of patients to define optimal clinical indications, timing, and dosing."

Retrospective data • CNS Disorders • Epilepsy

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

Enrollment open • Brain Cancer • Glioblastoma • Oncology • Solid Tumor

Refractory Partial Status Epilepticus in the Setting of Anti-GAD65 Autoimmune Encephalitis in an 18-Year-Old Female with an MRI Contraindication: A Case Report (AAN 2026) - "The patient had stopped Keppra due to side effects. She was then started on zonisamide...Acyclovir and fosphenytoin were initially started, with EEG continuing to show seizures...She was treated with multiple anti-epileptic drugs, IVIG, and later rituximab...She was discharged on fycompa, vimpat, and a prednisone taper with outpatient follow-up. This case highlights the importance of early diagnosis of anti-GAD65 autoimmune encephalitis in young patients with new-onset seizures, even without MRI. Prompt treatment, including PLEX, can prevent progression to status epilepticus and support recovery."

Case report • Clinical • CNS Disorders • Epilepsy • Immunology

Depressive Symptom Changes Following Antiseizure Medication (ASM) Use – A Quantitative Analysis of Clinical Studies (AAN 2026) - "Most anti-seizure medications were correlated with symptoms improvement, with the greatest effects observed for Perampanel (d = –0.77), Brivaracetam (d = –0.55), Lacosamide (d = –0.46), and Eslicarbazepine Acetate (d = –0.41). Decreases in depressive symptoms appear to be an underrecognized yet clinically meaningful secondary effect of antiseizure medications. These findings highlight specific medications that may provide the greatest benefit in co-morbid neuropsychiatric symptoms and underscore an importance of integrating psychiatric outcomes into epilepsy treatment decisions."

Clinical • CNS Disorders • Depression • Epilepsy

Brain with FIRES: A Pediatric Case of Therapeutic Synergism of Anakinra and IVIG (AAN 2026) - "Seizures were refractory to multiple antiseizure agents, high-dose methylprednisolone, ketamine, and pentobarbital coma. Plasmapheresis, pyridoxine challenge, propofol, intrathecal dexamethasone, and ketogenic diet for suspected FIRES were unsuccessful...His discharge regimen following 2 months of hospitalization included clobazam, perampanel, Anakinra, and IVIG... This case highlights a favorable response to combined immunotherapy in FIRES. Seizure recurrence during anakinra taper underscores its pivotal role, while improvement post-IVIG suggests synergistic benefit, emphasizing the need for further research into FIRES immunopathogenesis and combination strategies."

Clinical • CNS Disorders • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Pediatrics • Pneumococcal Infections • Pneumonia • Rare Diseases • IL2

Refractory Status Epilepticus in an Infant with Succinic Semialdehyde Dehydrogenase Deficiency: A Case Report and Therapeutic Challenges (AAN 2026) - "Despite treatment with lorazepam, levetiracetam, fosphenytoin, and phenobarbital, seizures persisted, evolving into refractory status epilepticus. Ketamine infusion was started and escalated to 100 mcg/kg/min without resolution...Both anesthetic infusions were weaned over 20 days, during which levetiracetam, topiramate, clobazam, perampanel, and phenobarbital were uptitrated... Epilepsy is a recognized feature of SSADHD, though its pathophysiology and optimal management remain poorly defined. Seizure type, frequency, and treatment response are highly variable, making therapy challenging. Status epilepticus in this setting presents unique therapeutic challenges, as many conventional antiseizure agents may exacerbate GABAergic imbalance; thus, management must balance seizure control while avoiding agents that impair GABA metabolism."

Case report • Clinical • Absence Seizure Disorder • Attention Deficit Hyperactivity Disorder • CNS Disorders • Epilepsy • Infectious Disease • Metabolic Disorders • Novel Coronavirus Disease • Strabismus

Early-stage clinical trial investigating the individual and combined effect of two drugs, senicapoc and perampanel, as part of the treatment for newly diagnosed glioblastoma, which is an aggressive brain tumor (clinicaltrialsregister.eu) - P1 | N=36 | Not yet recruiting | Sponsor: Region Midtjylland

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

Horner Syndrome Following Vagal Nerve Stimulator Implantation: A Rare Complication (AAN 2026) - "We report the case of a 16-year-old female with medically refractory epilepsy who developed clinical features of left-sided Horner syndrome immediately following VNS implantation.Design/ A 16-year-old female with drug-resistant epilepsy and a history of developmental delay secondary to childhood lead poisoning underwent VNS implantation after failing multiple anti-seizure medications, including levetiracetam, brivaracetam, oxcarbazepine, and perampanel. Horner syndrome is a rare but important complication of VNS implantation. With very few cases documented in the literature, it remains uncommon, and clinicians should maintain a high index of suspicion when characteristic signs appear postoperatively. The condition is likely caused by unintentional traction or injury to the sympathetic pathway during surgical manipulation near the carotid sheath."

CNS Disorders • Developmental Disorders • Epilepsy • Gastrointestinal Disorder • Infectious Disease • Ophthalmology • Otorhinolaryngology • Pulmonary Disease

Stimulus-induced Paradoxical Burst Suppression in a Patient with NORSE (AAN 2026) - "Despite broad antimicrobial therapy and multiple anti-seizure medications, including Perampanel and pentobarbital, the patient progressed to NORSE... This case illustrates the diagnostic and therapeutic challenges of NORSE and highlights paradoxical burst suppression as a distinct EEG phenomenon that can complicate interpretation. Recognition of its stimulus-dependent nature is important, as it may mimic pharmacologic burst suppression yet does not reliably indicate stable cortical quiescence. Careful differentiation is essential to avoid overestimation of seizure control during the management of refractory status epilepticus."

Clinical • IO biomarker • CNS Disorders • Epilepsy • Immunology

Neuroprotective effects of Vitamin D3 supplementation combination with valproate and perampanel in an experimental model using status epilepticus induction. (PubMed, Indian J Pharmacol) - "Vit-D3 supplementation, especially in combination with ASMs, showed promising neuroprotective effects in the SE model in rats by improving seizure control, memory, hippocampal health, and antioxidant levels."

Journal • CNS Disorders • Epilepsy • Inflammation • GFAP

Effectiveness and Safety of Perampanel in Patients with Lennox-Gastaut Syndrome: A Single-arm Meta-analysis with Meta-regression and Sensitivity Analyses (AAN 2026) - "Perampanel demonstrated clinically meaningful seizure reduction and acceptable tolerability in LGS. These results support its adjunctive use, though larger RCTs are needed to confirm long-term efficacy and safety."

Retrospective data • CNS Disorders • Epilepsy

Therapeutic Drug Monitoring of Clobazam, Perampanel, and Lacosamide Using a UPLC-MS/MS Method: Analysis of 5-Year Experience in a Large Cohort of Pediatric Epilepsy Patients From China. (PubMed, Biomed Chromatogr) - "All plasma samples could be maintained for up to 3 h at ambient temperature, 24 h at 4°C, 30 days at -30°C, and after successive freeze-thaw cycles in the absence of significant degradation. We successfully developed a simple and rapid LC-MS/MS method for the simultaneous measurement of three new generation ASMs, and successfully applied it to clinical practice."

Journal • CNS Disorders • Epilepsy • Pediatrics

Effect of adjunctive perampanel on daytime sleepiness and quality of life in adults with focal-onset seizures: Post hoc analyses of the AMPA study. (PubMed, Epilepsy Behav) - P | "In the FAS, adjunctive perampanel did not worsen daytime sleepiness for ≤ 12 months. In a small subset of patients, seizure frequency was reduced, regardless of ESS changes, and mean QoL at EoT was improved for those without excessive daytime sleepiness but declined for those with excessive daytime sleepiness. No new safety signals emerged."

HEOR • Journal • Retrospective data • CNS Disorders • Epilepsy • Excessive Daytime Sleepiness • Otorhinolaryngology • Sleep Disorder • Vertigo

Antiseizure Medications in Older Adults with Epilepsy: Considerations in Pharmacology, Safety, Tolerability, and Effectiveness of Newer Agents. (PubMed, Drugs Aging) - "Data from previous trials are reviewed for established agents (including levetiracetam, lamotrigine, carbamazepine, gabapentin, and pregabalin) as well as newer antiseizure medications such as lacosamide, brivaracetam, cenobamate, eslicarbazepine acetate, and perampanel. Overall, existing evidence supports the use of lower starting doses, slower titration schedules, and avoidance of enzyme-inducing antiseizure medications when possible in older adults. The heterogeneity of this population highlights the need for future studies stratified by frailty, cognitive status, and the living environment to better inform individualized tolerability-focused epilepsy care in later life."

Journal • Review • Alzheimer's Disease • Cardiovascular • CNS Disorders • Cognitive Disorders • Dementia • Depression • Epilepsy • Hepatology • Oncology • Osteoporosis • Psychiatry • Rheumatology