Lamotrigine and serious skin reactions

A skin rash occurs in 5-10% of patients treated with lamotrigine (typically within the first 6 weeks of treatment). Serious skin reactions occur in about 1 in 1000 patients, including Stevens Johnson syndrome and toxic epidermal necrolysis. The risk of serious skin reactions is much higher in children with a frequency of 1:300 to 1:100 (1).

Risk factors for the development of skin reactions include (2):

• concomitant use of sodium valproate
• exceeding the starting dose of lamotrigine
• exceeding rate of dose excalation of lamotrigine

Reference:

• Drugs and Therapeutics Bulletin (1992), 30 , 75-76.
• Current problems in pharmacovigilance (1997), 23, 8.