From the FDA Drug Label
INDICATIONS AND USAGE FYCOMPA, a non-competitive AMPA glutamate receptor antagonist, is indicated for: Treatment of partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy 4 years of age and older (1.1) Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with epilepsy 12 years of age and older (1.2) The uses of perampanel (Fycompa) are:
- Treatment of partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy 4 years of age and older
- Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with epilepsy 12 years of age and older 1
From the Research
Perampanel is primarily used to treat epilepsy, specifically as an adjunctive (add-on) therapy for partial-onset seizures with or without secondary generalization in patients aged 12 years and older, and for primary generalized tonic-clonic seizures in patients with epilepsy, as supported by the most recent study 2. The typical starting dose is 2 mg once daily taken at bedtime, which can be gradually increased by 2 mg increments at intervals of at least one week to a maintenance dose of 4-12 mg daily, depending on patient response and tolerability. Perampanel works by blocking AMPA glutamate receptors in the brain, which helps reduce excessive neuronal excitation that leads to seizures. This medication is particularly useful for patients whose seizures are not adequately controlled with other anti-epileptic drugs. Some key points to consider when using perampanel include:
- Common side effects include dizziness, somnolence, fatigue, irritability, and coordination problems, as reported in studies 3, 4, 5, 6.
- Patients should be monitored for psychiatric reactions including aggression, hostility, and behavioral changes, which can occur with perampanel, as noted in studies 3, 5, 6.
- The medication should be taken consistently at the same time each day, and should not be stopped abruptly as this may increase seizure frequency.
- Perampanel has been shown to be safe and effective in patients with various seizure types, including status epilepticus, myoclonic seizures, and absence seizures, as well as in patients with juvenile myoclonic epilepsy, Lennox-Gastaut syndrome, and elderly-onset epilepsy, according to the latest findings 2.
- Low-dose initiation and slow titration of perampanel can help minimize adverse events, as discussed in the review article 2.