Beasley, Allen, Crow, Methvin, Portis & Miles, P.C.

Children treated with lamotrigine for epilepsy who have a medical history of skin reactions to medication, use multiple drug therapies including the drug valproate, and cannot be adequately control their seizures with medication may be at greater risk for adverse skin reactions, according to Peer View Media Bar.

Lamotrigine is an anticonvulsant drug to treat partial seizures, primary and secondary tonic-clonic seizures in epilepsy and seizures associated with Lennox-Gastaut syndrome. It also is FDA-approved to treat bipolar disorder.

Peer View cited a session presented at the American Epilepsy Society’s annual meeting, which detailed a study, conducted between January 2000 and December 2007, involving 403 children treated with lamotrigine in addition to existing therapy. Twenty-one of the children in the study experienced adverse skin reactions including moderate diffuse mascular-papular or erythematous rash, severe urticarial skin eruption and mild Stevens Johnson Syndrome (SJS).

There were no cases of toxic epidermal necrolysis (TEN), a severe form of SJS, however the medication has a black box warning about life threatening skin reactions, including SJS and TEN. The manufacturer says the reactions usually occur in the first 2 to 8 weeks of therapy and if medication is suddenly stopped and then resumed at its regular dosage.

According to Rx List, the incidence of these serious skin rashes in response to therapy for epilepsy is about 8 in 1,000 in pediatric patients younger than 16 years of age and about 3 in 1,000 in adults. For treatment of bipolar disorder and other mood disorders, the rate is about 1.3 to 8 in 1,000 for adults.

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