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Perampanel-Induced Psychosis in a Young Woman: A Case Report
Ester Pujal Rodríguez1, María Teresa Pons-Cabrera1, Anna Giménez1
1Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia.
Clinical Neuropharmacology
|November 12, 2021
Summary
This case report details a rare instance of psychosis induced by perampanel, an antiepileptic drug. Comprehensive monitoring is crucial for patients on antiseizure medications due to potential psychiatric side effects.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Epilepsy management often involves antiepileptic drugs (AEDs).
- While effective, some AEDs carry risks of central nervous system and psychiatric adverse events.
- Perampanel is an AED targeting α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors.
Observation:
- A young woman with no prior psychiatric history developed psychosis and altered behavior.
- These symptoms emerged during treatment with perampanel for epilepsy.
- Hospitalization in an acute psychiatry ward was required.
Findings:
- Perampanel's mechanism involves partial blockade of AMPA receptor currents, which can lead to psychiatric symptoms.
- Psychiatric adverse events, though less common than neurological ones, are reported with perampanel.
- This case highlights a rare but severe adverse reaction to perampanel.
Implications:
- The biological vulnerability to AED-induced psychiatric reactions is complex and multifactorial.
- Individual patient factors and drug mechanisms may interact, predisposing individuals to adverse effects.
- Long-term and comprehensive clinical monitoring is essential for patients initiating AED therapy.
