The AMPA antagonist perampanel is proving to be an effective and well tolerated adjunctive treatment for people with drug-resistant epilepsy, Australian real world results suggest.
In a retrospective observational study of 387 patients managed in nine Australian epilepsy centres, late add-on treatment with perampanel resulted in 21.7% responder rates (at least 50% reduction in seizure frequency) and 9.0% seizure freedom after 12 months maintenance.
The one year retention rate on treatment was 40%, and it was assumed that missing cases were treatment failures.
Perampanel treatment was also generally well tolerated, with the main side effects being neuropsychiatric effects such as irritability (19%), dizziness (14%) and sleepiness (6%).
The study authors led by Dr Parveen Sagar of St Vincent’s Hospital Melbourne, said the responder rates were lower than reported in some other studies of perampanel but were nevertheless a favourable reflection of real world long term use. They were particularly good for  a group of patients with severe drug resistant epilepsy who had trialled an average six other antiepileptic drugs and of whom 72% had never experienced six months of seizure freedom prior to perampanel.