The Medical Letter on Drugs and Therapeutics
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Perampanel (Fycompa) for Epilepsy

Perampanel (per am' pa nel; Fycompa – Eisai), a first-in-class noncompetitive AMPA receptor antagonist, has been approved by the FDA for adjunctive treatment of partial-onset seizures in patients ≥12 years old. New drugs for epilepsy are often initially approved by the FDA as adjunctive treatment for partial seizures.1

MECHANISM OF ACTION — AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptors are a subtype of glutamate receptors. Perampanel is a noncompetitive antagonist of AMPA receptors on post-synaptic neurons. In vitro, it inhibits AMPA-dependent increases in intracellular calcium, but the mechanism by which it reduces seizure activity is unclear.2

CLINICAL STUDIES — Approval of perampanel was based on the results of 3 randomized, double-blind, placebo-controlled trials in ... more      

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