Roughly each one to two years, a new antiepileptic is introduced. Since only about half of them actually survives the academic (Pregabalin) and the economic (Trobalt) scrutiny of time, it might be too early to study those drugs before they have become established. On the other hand, we might be confronted with any of those drugs and then hard-pressed to decide whether to continue them or not in, say, status therapy. So we discuss the one scenario in which perampanel has actually been investigated (add-on therapy in focal epilepsy), think about how AEDs are escalated in general and then use the drug information as well as a recent article to understand possible places for this new drug in our approach to epilepsy (and maybe status). This all with the caveat that Fycompa might actually be turned down by the GBA (a german institution that regulates reimbursement). 


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