Increased risk of suicidality on perampanel (Fycompa®)?

Résumé

This article discusses three cases of suicidality in patients on perampanel (PER).We, therefore, are concerned about the risk of psychiatric adverse effects of PER, particularly suicidal ideas or behavior, which might have been underestimated. Case 1 is a 21-year-old woman with highly therapy-resistant focal epilepsy of unknown origin. She had suffered from simple and complex partial as well as generalized tonic–clonic seizures since the age of seven. Perampanel was immediately discontinued, and she recovered after a few days. Case 2 (22 years old, female) resembles case 1 in a number of aspects: focal epilepsy of unknown origin since the age of seven; partial and secondary generalized seizures; therapy resistance degree 3; no surgical option; and slight cognitive deficits. Case 3 is a 22-year-old man. His epilepsy and intellectual disability of moderate degree resulted from bilateral perisylvian polymicrogyria. All three patients have difficult-to-treat focal epilepsy. All have cognitive impairments albeit of different degrees. Particular concern arises from the fact that the emotional changes developed by the patients initially remained unnoticed by their surroundings. Only with a delay of weeks the suicidal ideas became apparent. (PsycINFO Database Record (c) 2014 APA, all rights reserved) PHARMACOTHÉRAPIE MÉDICAMENT EFFET-NÉGATIF