Exanthema after lamotrigine use: A clinical case

Abstract

Introduction: Lamotrigine is a phenyltriazine compound that inhibits sodium and potassium channels in presynaptic neurons. Maculopapular exanthema is a common side effect of Lamotrigine therapy, occurring most frequently during the first eight weeks of treatment in approximately 3–10% of patients. Case Report: A 74-year-old female had started Lamotrigine 50 mg due to emotional lability and depression. About 8–9 weeks after the introduction of the drug she presented a rash with exanthema, maculopapular in appearance. The attending physician suggested discontinuation of the medication and reevaluation. Complete regression of the clinical picture occurred. No severe skin rashes, including Stevens-Johnson syndrome and toxic epidermal necrolysis were observed. Conclusion: Lamotrigine is effective for a variety of types of conditions involving neuronal excitability, however, such drug exposes the individual to side reactions ranging from mild skin rashes to even those leading to hospitalization. Measures such as adherence to the manufacturer’s dosing guidelines, titration, and intrinsic characteristics of the individual can minimize this effect.