Successful re-introduction of lamotrigine after initial rash

The aim of this study was to determine whether lamotrigine can be re-introd uced safely and with a benefit in young people who previously had a mild ra sh associated with the first introduction of this drug. In the first 150 yo ung people (5-19 years old) treated with lamotrigine in a special centre fo r epilepsy, seven developed a mild rash soon after starting the drug. In no ne of these cases was the rash severe, nor was there any mucous membrane in volvement. The lamotrigine was stopped immediately when the rash was identi fied and was subsequently re-introduced, using a special very-low-dose-esca lation regime, starting with 0.1 mg/day total daily dose, after periods ran ging from 47 to 236 days. It was possible to re-introduce the lamotrigine w ithout recurrence of persistent rash and without any adverse effects in all seven cases. The re-introduction of lamotrigine was associated with improv ement in five of the seven cases. It is recommended that lamotrigine is sto pped as soon as any rash attributable to the drug develops but it may be po ssible to re-introduce the drug after mild rash using a very-slow-dose-esca lation regime, with a benefit in at least some cases. (C) 2000 BEA Trading Ltd.