Antiepileptic Drugs-induced Stevens-Johnson syndrome: A case Series

Trivedi, Bhavi; Darji, Nishita H.; Malhotra, Supriya D.; Patel, Pankaj

doi:10.4103/0976-0105.195130

Cited by 14 publications

(8 citation statements)

References 3 publications

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“…There are only a few case presentations of OXC-induced SJS in the literature [3, 9]. To the best of our knowledge, our patient is the youngest of all among the cases reported so far in the literature.…”

Section: Discussionmentioning

confidence: 78%

“…Although carbamazapine is the major anti-epileptic drug associated with SJS/TEN; OXC-induced SJS/TEN is extremely rare with the incidence of 0.5–6/1.000.000 in 1 year in normal population according to the FDA. There are only a few case presentations of OXC-induced SJS in the literature [ 3 , 9 ]. To the best of our knowledge, our patient is the youngest of all among the cases reported so far in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Oxcarbazepine-induced Stevens–Johnson syndrome: a pediatric case report

Beken

Can

Örencik

et al. 2017

Oxford Medical Case Reports

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Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis are two rare but life-threatening diseases characterized by detachment of epidermis, bullous skin lesions and mucous membrane erosions. Anti-epileptic drugs are highly suspected to be the causative agents. Although carbamazepine (CBZ) is the most associated anti-epileptic drug, oxcarbazepine (OXC), which is a monohydrated derivative of CBZ, is proposed to be safer because of the different metabolism of the two drugs. Herein, we report a case of SJS induced by oxcarbazepine. A 6-year-old boy with benign rolandic epilepsy, admitted to our hospital with generalized maculopapular rash after starting oxcarbazepine. The diagnosis of SJS was made with cytotoxic skin lesions and mucous membrane involvement. After discontinuing of the drug and topical corticosteroid initiation, the lesions were improved. We report this case to attract attention to the serious side effect of this anti-epileptic drug.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Oxcarbazepine-induced Stevens–Johnson syndrome: a pediatric case report

Beken

Can

Örencik

et al. 2017

Oxford Medical Case Reports

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“…Greater than 90 percent of SJS/TEN reactions associated with AEDs occur within the first 2 months of treatment initiation, 41 although some AEDs have been associated with such reactions during long term use (phenobarbital and valproic acid). 1 Previous studies have indicated that SJS/TEN reactions may be associated with the starting dose and rate of titration for some AEDs.…”

Section: Discussionmentioning

confidence: 99%

Stevens‐Johnson syndrome and toxic epidermal necrolysis with antiepileptic drugs: An analysis of the US Food and Drug Administration Adverse Event Reporting System

et al. 2018

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Summary Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and potentially fatal adverse skin reactions that are most commonly triggered by certain medications. One class of medications that have been highly associated with SJS/TEN reactions are antiepileptic drugs (AEDs). We sought to quantify the risk of SJS/TEN associated with AEDs as a class, as well as individual AEDs, in the United States. Methods: An analysis was performed of the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) from July 2014 through December 2017. Rates of SJS/TEN were calculated for each AED compared with all other non-AEDs. Reporting odds ratios (ROR), proportional reporting ratios (PRR), and 95% confidence intervals (CI) were calculated using OpenEpi. Results: AEDs had the most reports of SJS/TEN than any other medication class with 198 reports. AEDs as a class had a ROR of 8.7 (CI 7.5–10.2) and a PRR of 8.7 (CI 7.5–10.2) compared with all other non-AEDs. The AEDs with the highest risk estimates were zonisamide (ROR: 70.2, CI 33.1–148.7; PRR: 68.7, CI 32.9–143.5), rufinamide (ROR: 60.0, CI 8.3–433.5; PRR: 58.9, CI 8.4–411.5), clorazepate (ROR: 56.0, CI 7.8–404.1; PRR: 55.1, CI 7.8–385.0), lamotrigine (ROR: 53.0, CI 43.2–64.9; PRR: 52.2, CI 42.7–63.7), phenytoin (ROR: 26.3, CI 15.5–44.7; PRR: 26.1, CI 15.4–44.2), and carbamazepine (ROR: 24.5, CI 16.0–37.5; PRR: 24.3, CI 16.0–37.1).

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“…If the relationship between LTG accumulation in melanin-rich tissues and SJS is confirmed, it could lead to the development of better strategies to reduce the risk of SJS in individuals taking LTG. This could improve patient outcomes and increase the overall safety and efficacy of LTG as a treatment option [ 127 ].…”

Section: Side Effects Of Lamotriginementioning

confidence: 99%

Understanding Lamotrigine’s Role in the CNS and Possible Future Evolution

Costa

Vale

2023

IJMS

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The anti-epileptic drug lamotrigine (LTG) has been widely used to treat various neurological disorders, including epilepsy and bipolar disorder. However, its precise mechanism of action in the central nervous system (CNS) still needs to be determined. Recent studies have highlighted the involvement of LTG in modulating the activity of voltage-gated ion channels, particularly those related to the inhibition of neuronal excitability. Additionally, LTG has been found to have neuroprotective effects, potentially through the inhibition of glutamate release and the enhancement of GABAergic neurotransmission. LTG’s unique mechanism of action compared to other anti-epileptic drugs has led to the investigation of its use in treating other CNS disorders, such as neuropathic pain, PTSD, and major depressive disorder. Furthermore, the drug has been combined with other anti-epileptic drugs and mood stabilizers, which may enhance its therapeutic effects. In conclusion, LTG’s potential to modulate multiple neurotransmitters and ion channels in the CNS makes it a promising drug for treating various neurological disorders. As our understanding of its mechanism of action in the CNS continues to evolve, the potential for the drug to be used in new indications will also be explored.

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Antiepileptic Drugs-induced Stevens-Johnson syndrome: A case Series

Cited by 14 publications

References 3 publications

Oxcarbazepine-induced Stevens–Johnson syndrome: a pediatric case report

Oxcarbazepine-induced Stevens–Johnson syndrome: a pediatric case report

Stevens‐Johnson syndrome and toxic epidermal necrolysis with antiepileptic drugs: An analysis of the US Food and Drug Administration Adverse Event Reporting System

Understanding Lamotrigine’s Role in the CNS and Possible Future Evolution

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