Perampanel, approved for adjunctive treatment of focal and generalized tonic-clonic seizures, acts by a uniquely distinct mechanism compared to all other antiepileptic drugs. Its mechanism is:

• A Selective blockade of voltage-gated sodium channels in their inactivated state
• B Non-competitive antagonism at AMPA (alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) glutamate receptors ✓
• C Enhancement of GABA-A receptor chloride conductance
• D Inhibition of synaptic vesicle protein SV2A

Explanation

Perampanel is the only currently approved antiepileptic that acts as a selective, non-competitive AMPA receptor antagonist. AMPA receptors mediate the majority of fast excitatory synaptic transmission in the brain, and their antagonism reduces neuronal excitability and seizure propagation. Levetiracetam acts on SV2A; sodium channel blockers (carbamazepine, phenytoin) target Nav channels; benzodiazepines enhance GABA-A — making perampanel mechanistically distinct from all existing antiepileptics.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.