Patients with epilepsy have increased vulnerability to psychiatric comorbidity, including psychotic disorders, imposing additional disease burden. Among the types of psychotic disorders in epilepsy, antiepileptic drug (AED) induced psychotic disorder (AIPD) represents an iatrogenic adverse drug reaction, which prevalence ranges from 1% to 8,4% in clinical trials of AEDs. By definition, the definitive diagnosis of AIPD can only be made retrospectively. Perampanel (PER), a noncompetitive antagonist of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor, is the first agent developed as an adjunctive therapy for adults with focal seizures with or without secondary generalization. The profile of adverse reactions has been extensively studied, with emphasis on psychiatric side effects. The development of acute psychotic disorders as a side effect rarely occurs, ranging from 0,1% to 1,3% according to different studies and is poorly described.