Lamictal (lamotrigine) and new adverse effects./nA patient has seen a television program in TV1 rec

Fråga: Lamictal (lamotrigine) and new adverse effects. A patient has seen a television program in TV1 recently (last month) where lamotrigine was said to have serious side-effects on the brain. The questioner wants to have this confirmed.

Sammanfattning: No serious side-effects on the brain during the use of lamotrigine brain have been reported recently. However, lamotrigine in combination with valproic acid resulting in very high levels of lamotrigine has been reported to cause lamotrigine encephalopathy.

Svar: Since it was not specified which program it was, the responsible persons at the Sveriges Radio TV AB cannot help us with information about what had been said in the program.

We have done a literature search in Swedis, Medline and been in contact with the Medical Product Agency in Uppsala. Nowhere could we find information concerning side-effects on the brain induced by lamotrigine. However, lamotrigine encephalopathy has been reported recently (1) in Lancet. The patient had concomitantly been treated with valproic acid and lamotrigine, without lowering the dose of lamotrigine when valproic acid was instituted, resulting in toxic levels of lamotrigine which caused severe side-effects in the patient. A similar case has been reported to the Swedish Adverse Drug Reactions Advisory Committe (SADRAC).

Recently severe skin reactions, such as Stevens-Johnson syndrome (SJS), 4 cases, and toxic epidermal necrolysis (TEN), 3 cases, have been associated with lamotrigine and reported to SADRAC. This information was also published in the daily press during the summer.