Are there any serious skin adverse reactions described for gabapentin (Neurontin)?/nThe question co

Fråga: Are there any serious skin adverse reactions described for gabapentin (Neurontin)? The question concerns a 73-year-old woman with diabetes mellitus (treated with insulin once daily) and hypertension (treated with enalapril (Renitec) once daily) in her medical history. In October 1996 she had an episode of epileptical seizures (grand mal), probably a sequelae from a previous cerebral infarction in June 1996. Fenantoin therapy 100 mg x 2 is initiated. After this she has had no reoccurrence of seizures. In november she begins to develop skin rashes and itching. This further progresses during two weeks and a serious skin reaction (diagnosed as Lyell´s syndrome) develops. Both fenantoin and enalapril are then withdrawn. The patient slowly recovers. Gabapentin has been thought of as an alternative antiepileptic treatment.

Sammanfattning: We have found no reports of any serious skin adverse reactions due to gabapentin treatment. In clinical practise gabapentin is used as an add-on medication to other anticonvulsants in patients with refractory partial epilepsy. Documentation for its use as monotherapy is lacking. It could be noted in this case that both drugs, fenantoin and enalapril, may have contributed to the severe skin reaction the patient developed. As to the treatment of this patient it seems natural to first reconsider the need for antiepileptic treatment and if needed, carbamazepine may be a drug of choice although Lyell´s syndrom has also been reported for it.

Svar: Se sammanfattning/konklusjon.