Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2026 Jan 13;47(1):154.
doi: 10.1007/s10072-025-08785-5.

Sleep effects in drug-resistant epileptic patients taking perampanel: an observational study

Fabio Lamanna  1 , Orazio Pardeo  1 , Diana Tilenni  1 , Francesco Luppino  1 , Giuseppe Salafica  1 , Adele Barbaccia  1 , Angelina Laganà  1   2 , Irene Aricò  1   3 , Serena Raineri  1 , Giovanni Tripepi  4 , Rosalia Silvestri  1   3 , Angelo Labate  5
Affiliations
Observational Study

Sleep effects in drug-resistant epileptic patients taking perampanel: an observational study

Fabio Lamanna et al. Neurol Sci. .

Abstract

Background: Perampanel (PER) is a selective non-competitive antagonist of the AMPA receptor. While its efficacy in epilepsy very limited studies have focused on its impact on sleep quality, thus the aim of this study was to assess PER impact on sleep among patients with refractory epilepsy.

Methods: Patients were recruited at the Epilepsy Center of the University of Messina, Italy according to the ILAE criteria and received PER as an add-on therapy. Sleep quality (PSQI), daytime sleepiness (ESS), and quality of life (QOLIE-31) were assessed at baseline and follow-up. Efficacy was evaluated based on seizure frequency reduction and classified as worsened, unchanged, < 50% improvement, ≥ 50% improvement, or seizure-free. Patients were also stratified by use of perampanel as first or late add-on therapy. Tolerability was assessed through reported adverse events.

Results: Thirty-one patients were followed for six months; one was excluded due to seizure worsening. PER was first add-on in 11 patients, late add-on in 20. Sleep quality and daytime sleepiness showed slight improvement. QOLIE-31 scores showed a mild, non-significant improvement in quality of life, with a significant reduction in seizure worry in late add-on patients. In the first group, 100% were responders (≥ 50% seizure reduction), 27.2% seizure-free. In the late add-on group, 65% were responders, 30% seizure-free (p = 0.043). PER was well tolerated with no severe adverse events.

Significance: PER appears to preserve sleep quality and mildly improve quality of life. Furthermore, PER shows greater efficacy when used as a first add-on therapy in drug-resistant epilepsy.

Keywords: Drug-resistant; First add-on; Perampanel; Quality of life; Sleep quality; Somnolence.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical Publication Statement: We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. Conflict of interest: The authors declare that they have no conflicts of interest.

References

    1. Hanada T, Hashizume Y, Tokuhara N, Takenaka O, Kohmura N, Ogasawara A, Hatakeyama S, Ohgoh M, Ueno M, Nishizawa Y (2011) Perampanel: a novel, orally active, noncompetitive AMPA- receptor antagonist that reduces seizure activity in rodent models of epilepsy. Epilepsia 52:1331–1340. https://doi.org/10.1111/j.1528-1167.2011.03109 - DOI - PubMed
    1. Rogawski MA, Hanada T (2013) Preclinical Pharmacology of perampanel, a selective non- competitive AMPA receptor antago- Nist. Acta Neurol Scand Suppl 127:19–24. https://doi.org/10.1111/ane.12100 - DOI
    1. European Medicines Agency (EMA) Perampanel (Fycompa): Summary of Product Characteristics. Available at: https://www.ema.europa.eu/en/documents/productinformation/fycompa-epar-p...
    1. Nishida T, Lee SK, Inoue Y, Saeki K, Ishikawa K, Kaneko S (2018) Adjunctive perampanel in partial-onset seizures: Asia- Pacific, randomized phase III study. Acta Neurol Scand 137:392–399. https://doi.org/10.1111/ane.12883 - DOI - PubMed
    1. Pascarella A, Gasparini S, Manzo L, Marsico O, Torino C, Abelardo D, Cianci V, Iudice A, Bisulli F, Bonanni P, Caggia E, D’Aniello A, Di Bonaventura C, DiFrancesco JC, Domina E, Dono F, Gambardella A, Marini C, Marrelli A, Matricardi S, Morano A, Paladin F, Renna R, Piccioli M, Striano P, Ascoli M, Ferlazzo E, Aguglia U, PEROC Study Group (2023) Perampanel as only add-on epilepsy treatment in elderly: a subgroup analysis of real-world data from retrospective, multicenter, observational study. J Neurol Sci 455:122797. https://doi.org/10.1016/j.jns.2023.122797 - DOI - PubMed

Publication types

LinkOut - more resources