Epilepsy Talk

Perampanel — New Hope For Those With Uncontrollable Seizures | November 6, 2012

A new type of anti-epilepsy medication that selectively targets proteins in the brain, controlling excitability, has been developed by Johns Hopkins led researchers.

The purpose of this revolutionary new drug is to significantly reduce seizure frequency in people whose recurrent seizures have been resistant to even the latest medications.

In a multinational, blinded, placebo-controlled trial of more than 700 people with uncontrolled partial-onset seizures, roughly one-third of participants saw the frequency of their seizures fall by more than 50 percent when they were given 8 milligrams a day of Perampanel. Those in this trial typically had about 10 seizures a day!

The participants in the study, reported in the journal Neurology, were all taking one to three anti-epileptic drugs before adding Perampanel (or a placebo) to their regimen.

Perampanel (Fycompa) is the first product in this class, because of its success inhibiting the excess activity of a glutamate receptor (AMPA) in the brain.

Glutamate is a primary molecule in cellular metabolism that plays a key role in neurotransmission and is particularly abundant in the nervous system.

AMPA blocks the excessive activation by these receptors which damage brain cells by increasing the flow of calcium into the brain, leading to seizures.

Consequently, it helps reduce damage to brain cells and has been shown to cut the seizure rate by more than 50 per cent.

In short, Perampanel reduces treatment-resistant, partial-onset seizures by blocking the effects of glutamate, which can trigger and maintain seizures.

 In addition, Perampanel has the added benefit of convenient, once-daily dosing taken at bedtime, and it is the only contemporary epilepsy treatment approved for adolescents from launch which can lead to earlier seizure control in younger patients.

“I’m happy to say that this study was successful. Most of the epilepsy drugs we have available are either channel-acting drugs or have been working on the inhibitory side, increasing gamma-aminobutyric acid.

This is the first of the antiepileptic drugs (AEDs) that actually blocks the excitatory side — it’s an AMPA antagonist.

And my hope is that perhaps by blocking excess excitation, you might actually have the potential to decrease excitatory damage.” said Jacqueline A. French, MD, Director of the Clinical Trials Consortium at New York University’s Epilepsy Center.

Other drugs targeting glutamate receptors in the brain have tended to make patients too sleepy to function, even putting them in comas. And Perampanel carries its own side-effects, too: The risk of serious neuropsychiatric events — extreme changes in one’s mental state. (Better than Keppra? We’ll see.)

“Many other drugs to treat frequent seizures have been released in the last 10 years and for many people, they just don’t work,” says study leader Gregory L. Krauss, M.D., a professor of neurology at the Johns Hopkins University School of Medicine.

“For a drug-resistant population that has run out of options, this study is good news. These are patients who are tough to treat and are fairly desperate.”

On October 24, 2012 the FDA approved Perampanel as an adjunct treatment for refractory partial-onset seizures in patients with epilepsy aged 12 years and older. A step forward for us all.

“Improving seizure control is one of the most pressing unmet needs in epilepsy patients. Perampanel will be a new option for the adjunctive treatment of patients with uncontrolled seizures,” noted Professor Bernhard Steinhoff, Professor of Neurology, Medical Director and Executive, EpilepsyCenter, Kehl-Kork, Germany.

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Another article of interest:

Study shows Fycompa® (perampanel) provides sustained seizure control for people living with epilepsy  http://www.medicalnewstoday.com/releases/276889.php?tw











  1. This sounds perfect for me, however Keppra was a nightmare. My husband took the hunting rifles out of the house because of Keppra. It’s scary to think of what these pills do to your mind. I’m very skeptical now!!! But, yes I am desperate!!!


    Comment by cmaclean44 — November 6, 2012 @ 12:17 PM

    • I don’t know if this is good news or bad news, but the FDA made the drug go through rigorous trials before it was accepted.

      In fact, it was refused once and in an unusual move, the FDA allowed Perampanel to reapply, after meeting the necessary safety steps.

      The ultimate question: Is it better to deal with the devil you know (Keppra) or the devil you don’t know?

      I guess it depends upon your personal situation…


      Comment by Phylis Feiner Johnson — November 6, 2012 @ 12:28 PM

  2. So far, the ALTERNATIVES & OPTIONS has been very, very limited & daunting,

    Therefore, ANYTHING, just anything to control, minimize or stop this menace is great hope, for HOPE is precious treasure, when EVERYTHING else seems falling down.

    The more the variables, the BETTER the alternatives & choices & chances of getting it right.

    Great going,,, Phyllis,
    Thank you for the great news -:)


    Comment by Gerrie — November 6, 2012 @ 9:37 PM

  3. Well with the new Portiga in place and Perampanel (which I have very high hopes for) there IS room for hope.

    Fingers crossed!


    Comment by Phylis Feiner Johnson — November 7, 2012 @ 12:35 PM

    • Please don’t get me wrong, I do have hope and I do appreciate all the info you post Phylis!! It is a big question mark for me though. I have a lot of allergies and drugs sometimes do a number on me.


      Comment by cmaclean44 — November 8, 2012 @ 3:28 AM

  4. that does sound hopeful, I guess the devil you know v’s the devil you don’t is a good assessment. Do you know any more about why it had to reapply?


    Comment by epilepsymeandneurology — November 8, 2012 @ 12:40 PM

    • “Upon preliminary review, the FDA requested reformatting and reanalyses of some datasets in the dossier to assist with a substantive review. Eisai believes that no new non-clinical or clinical studies are required to support this filing. This letter does not comment on the approvability of the drug, and no determination has been made with regard to the efficacy or safety of perampanel as part of the letter.”

      If you can inderstand that, you’re doing better than me!!! 🙂

      Read more: U.S. FDA Provides Response to Perampanel New Drug Application – FierceBiotech http://www.fiercebiotech.com/press-releases/us-fda-provides-response-perampanel-new-drug-application-0#ixzz2BfCN8xjo


      Comment by Phylis Feiner Johnson — November 8, 2012 @ 3:07 PM

      • good grief! with that much verbal wrapping paper its difficult to know if they are sugar coating it or just using legal jargon. i will have a look, thanks.


        Comment by epilepsymeandneurology — November 8, 2012 @ 3:19 PM

  5. Reblogged this on epilepsy me and neurology and commented:
    An interesting post from accross the pond (click to link) from Epilepsytalk on new developments in medication for uncontrolled seizures.


    Comment by epilepsymeandneurology — November 8, 2012 @ 12:43 PM

  6. Dr. Krauss calls us “fairly desperate”? I do believe that is the understatement of the decade….


    Comment by Kim Scruggs — April 13, 2013 @ 5:58 PM

    • Perhaps he has a flair for the obvious. Or perhaps it’s time for a new doc….

      2013 Comprehensive List of GOOD Neurologists…Epileptologists…Neurosurgeons…and Pediatric Doctors



      Comment by Phylis Feiner Johnson — April 14, 2013 @ 9:09 AM

      • I was just quoting Dr. Krauss from the above article. We have a fantastic epileptologist at LeBonheur Children’s Hospital in Memphis, TN, Dr. Stephen Fulton. Our pediatric neurologist is Dr. Barbara Olsen in Nashville, TN. They are both wonderful…and would NEVER in a million years discount how desperate we are to find a solution for our son’s uncontrolled seizures. In fact, he was even in a clinical trial with Dr. Fulton for potiga/ezogabine metabolism/effects on kids, ages 12-18. At least he was until last Thursday when the FDA decided to stop the trial. So, for now, we just keep searching!

        Thanks for your blog and the info you give us.


        Comment by Kim Scruggs — April 15, 2013 @ 2:58 PM

  7. Kim — Thank YOU for sharing your resources with us.

    I did NOT have Dr. Stephen Fulton on the List of “Top Docs”.

    Now he’s been added so others can benefit from your experiences and contribution!

    Thanks again.


    Comment by Phylis Feiner Johnson — April 15, 2013 @ 3:41 PM

  8. My son has head drop and tonic clonic seizures. Dr Perry first gave him depakote and it stopped his head drop. He just gave him fycompa and he is now seizure free. Thank you to doctor Michael Perry at Cook Childrens in Fort Worth, TX.


    Comment by Justin Nguyen — October 28, 2015 @ 4:24 PM

  9. Reblogged this on epilepsylifechanger and commented:
    I take this and it has changed my whole life, it’s wonderful.


    Comment by toriandbilly — March 9, 2016 @ 12:12 PM

  10. Great news!


    Comment by Phylis Feiner Johnson — March 9, 2016 @ 12:55 PM

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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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