A case report of seizure worsening after perampanel add-on to oxcarbazepine: possible role of metabolic interaction and pharmacogenetics.

IF 3.2 3区医学 Q2 PSYCHIATRY

Frontiers in Psychiatry Pub Date : 2025-09-23 eCollection Date: 2025-01-01 DOI:10.3389/fpsyt.2025.1621598

Xin Fang, Menglu Zhu, Lijiang Wang

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引用次数: 0

Abstract

Objective: To investigate the factors contributing to increased seizure frequency in patients treated with a combination of oxcarbazepine (OXC) and perampanel.

Methods: The influence of the combined use of perampanel and oxcarbazepine on pharmacokinetics was analyzed, and the results were further confirmed by scoring the Naranjo Adverse Reaction Scale. The influence of race on antiseizure medications (ASMs) was also analyzed.

Results: The concomitant use of perampanel and oxcarbazepine increased the plasma concentration of oxcarbazepine. Scoring with the Naranjo adverse reaction scale indicated that the deterioration of seizures in patients following the addition of perampanel may be associated with the interaction of the two drugs.

Conclusion: The exacerbation of epilepsy in patients may be attributed to the increased blood concentration of oxcarbazepine resulting from its combination with perampanel, which potentially triggers a worsening of seizures. Variations in gene mutations related to Asian factors, as well as differences in drug metabolism enzymes and transporters, may also contribute to alterations in the concentration of ASMs.

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perampanel加用奥卡西平后癫痫发作恶化的病例报告：代谢相互作用和药物遗传学的可能作用。

目的：探讨奥卡西平（OXC）联合perampanel治疗患者癫痫发作频率增加的影响因素。方法：分析perampanel与奥卡西平合用对药代动力学的影响，并通过Naranjo不良反应量表评分进一步证实结果。还分析了种族对抗癫痫药物（asm）的影响。结果：perampanel与奥卡西平合用可使奥卡西平血药浓度升高。用Naranjo不良反应量表进行评分表明，加入perampanel后患者癫痫发作的恶化可能与两种药物的相互作用有关。结论：奥卡西平与perampanel联用可能导致奥卡西平血药浓度升高，可能引发癫痫发作加重。与亚洲因素相关的基因突变变异，以及药物代谢酶和转运体的差异，也可能导致asm浓度的改变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Psychiatry Medicine-Psychiatry and Mental Health

CiteScore

6.20

自引率

8.50%

发文量

2813

审稿时长

14 weeks

期刊介绍： Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.