Lamotrigine is FDA-approved as a maintenance treatment of bipolar disorder, but its common off-label uses include bipolar depression and antidepressant augmentation in patients with major depressive disorder. Among other adverse effects, cutaneous reactions, particularly erythema multiforme, are cited as concerns during treatment with this medication. In order to minimize the risk of cutaneous side effect, efforts have been made to identify factors associated with a higher rate of lamotrigine-induced rash. We report here a case of Drug Reaction with Eosinophilia and Systemic Symptoms apparently precipitated by the associated use of lamotrigine and cyclobenzaprine.
LorbergBYoussefNABhagwagarZ. Lamotrigine-associated rash: To rechallenge or not to rechallenge?International Journal of Neuropsychopharmacology2009;12(2):257–265.
2.
AikenCBOrrC. Rechallenge with lamotrigine after a rash: A prospective case series and review of the literature. Psychiatry (Edgmont)2010;7(5):27–32.
3.
CalabreseJRSullivanJRBowdenCLSuppesTGoldbergJFSachsGSSheltonMDGoodwinFKFryeMAKusumakarV. Rash in multicenter trials of lamotrigine in mood disorders: Clinical relevance and management. Journal of Clinical Psychiatry2002;63(11):1012–1019.
4.
ScaparrottaAVerrottiAConsilvioNPCingolaniADi PiloSDi GioacchinoMVeriniMChiarelliF. Pathogenesis and clinical approaches to anticonvulsant hypersensitivity syndrome: Current state of knowledge. International Journal of Immunopathology and Pharmacology2011;24(2):277–284.
5.
KumariRTimshinaDThappaDM. Drug hypersensitivity syndrome. Indian Journal of Dermatology, Venereology and Leprology2011;77(1):7–15.
6.
GordonJSNeymanKMWellsRDChenSC. Drug rash with eosinophilia and systemic symptoms (DRESS syndrome). Cutis2012;89(4):180–182.
