Lamotrigine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis.

Background. Lamotrigine is a new anticonvulsant belonging to the triazine f amily. Several cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been described in patients taking this drug. We repor t 2 cases in children attenting the same hospital. Case reports, Two children, aged 9 and 13 years, developed SJS and TEN resp ectively, 3 and 28 days after lamotrigine was added to their usual anticonv ulsant regimen. In both cases, outcome was favorable despite major decline in psychomotor capacity in one. In the first case, chronological attributab ility was plausible for lamotrigine and doubtful for sodium valproate, clon azepam and hydrocortisone. In the second case, chronological attributabilit y was probable for amoxicillin, plausible for lamotrigine and doubtful for sodium valproate, but the numerous previous absorptions of amoxicillin made lamotrigine more suspect. Discussion. The risk of Steven-Johnson syndrome and toxic epidermal necroly sis is high with lamotrigine with an estimated frequency of 1/1000. This ri sk is probably higher than with other anticonvulsants. Associating lamotrig ine with sodium valproate increases the frequency of adverse skin reactions .