Allergy Asthma Respir Dis.  2023 Apr;11(2):72-76. 10.4168/aard.2023.11.2.72.

Changes in prescribing patterns and resultant disease control after lamotrigine-related adverse drug reactions: A descriptive analysis

• Kang JE
• Lee KH
• Seo BC
• Lim JM
• Suh SY
• Cho YS
• Suh DI

• KMID: 2541971
• DOI: http://doi.org/10.4168/aard.2023.11.2.72

Abstract

Purpose
This study aimed to describe the desperate situation where the clinician should make decisions to further manage patients having experienced adverse drug reaction (ADR) to lamotrigine that is indicated to not easily controlled neuropsychiatric diseases.
Methods
A descriptive analysis was done by thoroughly reviewing medical records of patients who were reported to have ADR to lamotrigine in a regional drug-safety center between 2010 and 2018.
Results
Eighty-four cases of lamotrigine-related ADRs occurred in 80 patients. Skin lesions were most commonly observed in 70 cases (83.3%) and 14 cases (16.7%) had severe ADRs. Sixty-three subjects (78.8%) discontinued lamotrigine, while 17 (21.3%) continued it. At the time of discontinuation, 30.0% were prescribed aromatic antiepileptic drugs. Among 4 subjects who were eventually prescribed lamotrigine again after a period of discontinuation, 3 (75.0%) experienced its recurrence. Among patients who had taken alternative medications, the incidence of ADRs was higher in those being prescribed aromatic antiepileptic drugs than in the others being prescribed other than aromatic antiepileptic drugs (P = 0.013). Regarding the control of underlying diseases, as many as 65 (86.7%) and 68 (90.7%) failed to reach maintaining the resolved state from 6 months and 12 months after the substitution, respectively.
Conclusion
Patients can be easily trapped between the recurrence of ADRs and the treatment failure to a certain drug like lamotrigine, in which we can hardly find a reasonable alternative to manage them.

Keyword

Adverse drug reactions; Lamotrigine; Severe cutaneous adverse reactions; Prescription changing patterns; Disease control outcome