BACKGROUND: The use of lamotrigine is increasing. Many general practitioners prescribe it in the treatment of epilepsy and as a mood stabilising agent. It has also been suggested as the agent of choice in pregnant women with epilepsy. OBJECTIVE: This article describes the case histories of two patients who present with oral lesions and an extensive rash after starting treatment with lamotrigine. DISCUSSION: Toxic epidermal necrolysis (TEN) is a potentially fatal adverse mucocutaneous drug reaction. Simple maculopapular rashes occur commonly with lamotrigrine. Although rare, serious mucocutaneous reactions such as TEN can occur soon after commencement of treatment with lamotrigine, or after a dose increase in patients already established on treatment. The risk can be minimised by commencing at a low dose, avoiding rapid increases in dosage, and avoiding concomitant use of sodium valproate.
BACKGROUND: The use of lamotrigine is increasing. Many general practitioners prescribe it in the treatment of epilepsy and as a mood stabilising agent. It has also been suggested as the agent of choice in pregnant women with epilepsy. OBJECTIVE: This article describes the case histories of two patients who present with oral lesions and an extensive rash after starting treatment with lamotrigine. DISCUSSION: Toxic epidermal necrolysis (TEN) is a potentially fatal adverse mucocutaneous drug reaction. Simple maculopapular rashes occur commonly with lamotrigrine. Although rare, serious mucocutaneous reactions such as TEN can occur soon after commencement of treatment with lamotrigine, or after a dose increase in patients already established on treatment. The risk can be minimised by commencing at a low dose, avoiding rapid increases in dosage, and avoiding concomitant use of sodium valproate.
Authors: Amber N Edinoff; Long H Nguyen; Mary Jo Fitz-Gerald; Erin Crane; Kyle Lewis; Samantha St Pierre; Alan D Kaye; Adam M Kaye; Jessica S Kaye; Rachel J Kaye; Sonja A Gennuso; Giustino Varrassi; Omar Viswanath; Ivan Urits Journal: Psychopharmacol Bull Date: 2021-03-16