How do you prescribe Perampanel for use in patients with refractory status epilepticus?

LD: 6-12 mg

MD: 12 mg/day

Use not recommended in severe renal impairment (CrCl <30 ml/min).

Consider dose reduction in mild to moderate hepatic impairment. Use is not recommended in severe hepatic impairment.

There are no set recommendations and I can only report anecdotal evidence. For refractory or super-refractory status epilepticus, a loading dose of 24mg followed by maintenance of 12mg bid is well tolerated at least as per my experience. I have had success with several super-refractory epilepsy pati...