Perampanel May Increase Scores Indicative of Aggression, Depression in Epilepsy

Brain, EEG, Seizure
Brain, EEG, Seizure
Perampanel therapy was found to increase aggression and depression in patients with epilepsy.

For patients with epilepsy, treatment with perampanel increases both aggression and depression significantly, according to results published in the journal Seizure.

The study included participants with epilepsy who were given perampanel (n=77). Examinations were performed at baseline (before perampanel administration) and after 12-weeks of follow-up. At each examination, the researchers used the Buss Perry Aggression Questionnaire (BAQ) and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) to assess aggression and depression, respectively.

A total of 59 participants completed the study, with 3.9% discontinuing perampanel because of adverse psychiatric effects.

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The results indicated that compared with baseline, total BAQ and NDDI-E scores were significantly increased at 12 weeks (P =.013 and P =.000, respectively). When the researchers performed a subscale analysis for the BAQ, they found a significant increase in verbal aggression (P =.045) and physical aggression (P=.040), an increasing trend in anger (P =.083), and no significant difference or trend in hostility.

After performing multivariate analysis, the researchers found that concomitant antiepileptic drug administration did not have a significant impact on the increase of BAQ or NDDI-E score.

The results indicated that there was a dose-dependent effect of perampanel on BAQ, but this effect was not seen for NDDI-E results.

Age at epilepsy onset (P =.033), total BAQ score at entry point (P =.021), and dose of perampanel at end point (P=.021) were all independently associated with increase in BAQ.

“The present report presents the first prospective results suggesting that perampanel administration increases scores of assessment tools indicative of aggression and depression, as well as the dose-dependent nature of its effect on aggression,” the researchers concluded.

Disclosures: Dr Kanemoto reports receiving speaker’s fees from Esai, Daiichi-Sankyo, UCB Japan, and Otsuka Pharmaceutical Company.


Goji H, Kanemoto K. The effect of perampanel on aggression and depression in patients with epilepsy: a short-term prospective study. Seizure. 2019;67:1-4.