Perampanel, a newer antiepileptic approved for focal and generalised tonic-clonic seizures, exerts its effect by which unique mechanism not shared by any other currently marketed antiepileptic?

• A Selective NMDA receptor antagonism at the glycine-B site
• B Non-competitive AMPA receptor antagonism ✓
• C Synaptic vesicle protein SV2A binding
• D T-type voltage-gated calcium channel blockade

Explanation

Perampanel is the first and currently only antiepileptic that acts as a selective, non-competitive antagonist of ionotropic AMPA (alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) glutamate receptors. By blocking AMPA receptors, it reduces fast excitatory neurotransmission without affecting NMDA receptors. This makes its mechanism entirely distinct from all other AEDs. Levetiracetam and brivaracetam bind SV2A; ethosuximide and zonisamide block T-type calcium channels; felbamate has NMDA-glycine site activity but also has multiple other targets.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.