Santamarina E, Bertol V, Garayoa V, et al. - This study was undertaken to evaluate the effectiveness and tolerability of perampanel (PER) when administered as a first add-on therapy to patients with focal epilepsy or idiopathic generalized epilepsy (IGE) taking one other antiseizure drug (ASD). Researchers performed a multicentre, retrospective, one-year observational study using data from patients ≥12 years old who initiated treatment with PER as the first add-on therapy. A total of 149 patients (mean age 41 years; 54.4 % male) were included in the study, 118 (79.2 %) of whom were still receiving PER as first add-on treatment after 12 months. It was reported that in patients who did not respond to monotherapy, PER demonstrated a good effectiveness and safety profile when applied as a first add-on therapy. The results exhibited that, when combined with strong enzyme-inducing or enzyme-inhibiting ASDs, PER dose adjustments may optimize seizure control.