Perampanel is an anti-epileptic drug prescribed to manage seizures. It is used to control abnormal electrical activity in the brain that leads to seizures. It represents a treatment option for individuals experiencing certain types of seizure disorders.
Understanding Perampanel and Its Purpose
Perampanel is an anti-epileptic medication specifically approved for treating partial-onset seizures, which may or may not spread to become generalized seizures. It is also used as an add-on therapy for primary generalized tonic-clonic seizures, a type of seizure affecting the entire brain. This medication is typically prescribed for individuals 12 years of age and older and is often used in conjunction with other anti-seizure medications to provide more comprehensive seizure control.
How Perampanel Works in the Brain
Perampanel works by targeting specific sites in the brain known as AMPA receptors. These receptors are activated by a neurotransmitter called glutamate, which plays a role in excitatory signaling between brain cells. When glutamate binds to AMPA receptors, it can increase brain activity.
Perampanel acts as a selective non-competitive antagonist of these AMPA receptors. This means it attaches to a different site on the receptor than glutamate, but still prevents glutamate from causing its usual excitatory effect. By reducing this excessive excitatory neurotransmission, perampanel helps to stabilize electrical activity in the brain and reduce the likelihood of seizures.
Practical Information for Patients
Perampanel is typically taken once daily, usually by mouth, as either a tablet or an oral suspension. This once-daily dosing is possible due to its prolonged terminal half-life in humans, which is approximately 105 hours. Taking the medication at bedtime can help mitigate some of its common side effects.
Common side effects associated with perampanel include dizziness, fatigue, somnolence (drowsiness), and irritability. Patients may also experience nausea, headache, or weight gain. Other reported effects include vertigo, problems with balance or coordination, and bruising.
Important Safety Considerations
Perampanel is associated with potential psychiatric and behavioral changes. These can include aggression, hostility, irritability, anger, and even suicidal thoughts or behavior. These reactions have been observed in patients with and without a prior history of psychiatric issues. It is important for patients, their families, and caregivers to monitor for any new or worsening mood or behavior changes, especially when starting the medication or adjusting the dose.
The medication also poses a potential risk of fetal harm if taken during pregnancy. Animal studies have indicated this risk, making it important for women who may become pregnant to discuss contraception options with their healthcare provider. Perampanel has been shown to reduce the effectiveness of hormonal birth control containing levonorgestrel by approximately 40%. Therefore, alternative or additional non-hormonal birth control methods, such as barrier methods, are recommended for at least one month after the last dose.
Furthermore, perampanel is classified as a Schedule III controlled substance due to its potential for abuse. Very high doses have produced euphoric and dissociative effects similar to ketamine. Patients should inform their doctor if they have a history of substance abuse or dependence.