Allergic skin rash with lamotrigine and concomitant valproate therapy: evidence for an increased risk

Li, L. M.; Russo, M.; O'Donoghue, M. F.; Duncan, J. S.; Sander, J. W. A. S.

doi:10.1590/S0004-282X1996000100008

Abstracts

Cutaneous rash is one of the commonest adverse events associated with lamotrigine. We assessed whether the risk is increased in patients receiving concomitant valproate therapy in a population of 103 adult patients with intractable epilepsy, who had lamotrigine added to their treatment. Of the 33 patients taking valproate, 10 (30%) developed a rash, whilst of the 70 not taking valproate, only 6 (8%) developed a rash. This suggests a significantly higher risk of cutaneous rash when starting lamotrigine in patients already taking valproate (p<0.02).

allergic skin rash; antiepileptic drugs; lamotrigine; valproate

Rash cutâneo é um dos efeitos adversos mais comuns associados ao início de tratamento com lamotrigina, uma nova medicação antiepiléptica. Avaliamos se esse risco é maior em pacientes medicados concomitantemente com valproato em 103 pacientes adultos com epilepsia refratária, que tiveram lamotrigina adicionada a seu tratamento. Dez dos 33 pacientes (30%) que faziam uso de valproato e 6 (8%) dos 70 pacientes que não usaram valproato desenvolveram rash. Isto sugere que existe maior risco de desenvolver rash cutâneo quando se adiciona lamotrigina em pacientes em uso de valproato (p<0,02).

rash cutâneo; drogas antiepilépticas; lamotrigina; valproato

L. M. Li^I; M. Russo^II; M. F. O'Donoghue^III; J. S. Duncan^IV; J. W. A. S. Sander^V

^IEpilepsy Research Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London and The National Hospital - Chalfont Centre for Epilepsy, Gerrards Cross, United Kingdom: MD, Research Fellow in Clinical Neurophysiology

^IIEpilepsy Research Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London and The National Hospital - Chalfont Centre for Epilepsy, Gerrards Cross, United Kingdom: MD, Major (Neurologist) U.S. Army Medical Corps

^IIIEpilepsy Research Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London and The National Hospital - Chalfont Centre for Epilepsy, Gerrards Cross, United Kingdom: MRCP, Registrar in Clinical Neurology

^IVEpilepsy Research Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London and The National Hospital - Chalfont Centre for Epilepsy, Gerrards Cross, United Kingdom: DM, FRCP, Consultant and Senior Lecturer in Clinical Neurology

^VEpilepsy Research Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London and The National Hospital - Chalfont Centre for Epilepsy, Gerrards Cross, United Kingdom: MD, PhD, Consultant and Senior Lecturer in Clinical Neurology

ABSTRACT

Cutaneous rash is one of the commonest adverse events associated with lamotrigine. We assessed whether the risk is increased in patients receiving concomitant valproate therapy in a population of 103 adult patients with intractable epilepsy, who had lamotrigine added to their treatment. Of the 33 patients taking valproate, 10 (30%) developed a rash, whilst of the 70 not taking valproate, only 6 (8%) developed a rash. This suggests a significantly higher risk of cutaneous rash when starting lamotrigine in patients already taking valproate (p<0.02).

Key words:allergic skin rash, antiepileptic drugs, lamotrigine, valproate.

RESUMO

Rash cutâneo é um dos efeitos adversos mais comuns associados ao início de tratamento com lamotrigina, uma nova medicação antiepiléptica. Avaliamos se esse risco é maior em pacientes medicados concomitantemente com valproato em 103 pacientes adultos com epilepsia refratária, que tiveram lamotrigina adicionada a seu tratamento. Dez dos 33 pacientes (30%) que faziam uso de valproato e 6 (8%) dos 70 pacientes que não usaram valproato desenvolveram rash. Isto sugere que existe maior risco de desenvolver rash cutâneo quando se adiciona lamotrigina em pacientes em uso de valproato (p<0,02).

Palavras-chave:rash cutâneo, drogas antiepilépticas, lamotrigina, valproato.

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Acknowledgement - Dr Li Li Min is grateful for support from the National Society for Epilepsy -United Kingdom.

Aceite: 18-outubro-1995.

J.W.A.S. Sander, MD PhD - The National Hospital I Chalfont Centre for Epilepsy - Chalfont St. Peter - Gerrards Cross, Bucks SL9 ORJ, United Kingdom. FAX 44 1 494 873991.

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