Adverse events during perampanel adjunctive therapy in intractable epilepsy

Song Ee Youn, Se Hee Kim, Ara Ko, Sun Ho Lee, Young Mock Lee, Hoon Chul Kang, Joon Soo Lee, Heung Dong Kim

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background and Purpose Perampanel is the first α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA)-receptor antagonist developed to treat epilepsy. The effects of either rapid or slow dose titration on adverse events remain to be elucidated. Methods Eighty-five patients received perampanel between March 2016 and August 2016. Patients were divided into two groups according to their dosing schedule: rapid dose titration (2-mg increments at intervals of 1 to 2 weeks) and slow dose titration (2-mg increments at intervals of at least 3 weeks). Seizure frequency and adverse events were analyzed over 3 months. Results Adverse events were reported by 47 (58%) of the 81 patients analyzed, with 12 (15%) patients discontinuing perampanel due to adverse events. Common adverse events included dizziness (n=30, 37%), aggressive mood and behavior (n=19, 24%), gait disturbance (n=16, 20%), and sleep problems (n=10, 12.4%). The overall adverse events were similar in the slow-titration group (38 of 61 patients) and the rapid-titration group (8 of 20 patients, p=0.081). However, none of the 20 patients in the slow-titration group experienced gait disturbance, compared with 16 of the 61 patients in the rapid-titration group (p=0.009), while appetite change was experienced by 4 patients in the slow-titration group but only 1 in the rapid-titration group (p=0.003). No relationship was noted between adverse events and the maximum dose of perampanel (p=0.116). Sex differences were observed, with the response to perampanel being better and the rate of adverse events being higher in females (p=0.015 and p=0.046, respectively). Conclusions Slow titration of perampanel may reduce perampanel-related adverse events.

Original languageEnglish
Pages (from-to)296-302
Number of pages7
JournalJournal of Clinical Neurology (Korea)
Issue number3
Publication statusPublished - 2018 Jul

Bibliographical note

Publisher Copyright:
© 2018 Korean Neurological Association.

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology


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