Perampanel: Medical Alternative for Essential Tremor?

Clin Neuropharmacol. 2023 Mar-Apr;46(2):51-54. doi: 10.1097/WNF.0000000000000541. Epub 2023 Jan 25.

Abstract

Objectives: The aim of this study was to assess the safety and efficacy of perampanel in patients with refractory essential tremor (ET).

Methods: We recruited patients from our movement disorders clinic with the diagnosis of severe refractory ET, and perampanel 4 mg at night was initiated.Assessments were conducted at baseline and after 1 month of treatment with perampanel 4 mg/d. Details about tolerance and effectiveness were collected. Clinical evaluation was conducted with the Fahn-Tolosa-Marín scale, and statistical analysis was carried out with Wilcoxon matched pairs signed rank test.

Results: This study included 18 patients with severe ET (11 females, 7 males; mean age: 75.1 ± 12.03 years; mean duration of ET: 17.4 ± 17.03 years). Perampanel significantly improved patients' average score with refractory ET ( P ≤ 0.0001). This improvement has been occasionally quite relevant. However, a proportion of patients did not tolerate perampanel because of several adverse effects including dizziness, ataxia, irritability, and instability.

Conclusions: Perampanel had a markedly positive antitremor effect in patients with ET and could be an alternative treatment. However, this drug is not devoid of adverse effects.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticonvulsants / therapeutic use
  • Essential Tremor* / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nitriles
  • Pyridones / therapeutic use
  • Treatment Outcome

Substances

  • perampanel
  • Nitriles
  • Pyridones
  • Anticonvulsants