Development of an incipient Stevens–Johnson reaction while on a stable dose of lamotrigine

Parker, Gordon

doi:10.1177/1039856215612993

Cited by 5 publications

(1 citation statement)

References 2 publications

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“…In an earlier paper published in this journal, 1 two concerning patterns were noted as associated with some generic preparations of lamotrigine prescribed to those with a bipolar disorder. Firstly, those who have mood stability and no side-effects on the non-generic (branded) product but, following transfer to a generic, report mood swings returning, and mood stability regained on resuming the branded product.…”

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confidence: 98%

Quality control concerns in relation to lamotrigine and their impact

Parker

Jenner

2022

Australas Psychiatry

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Objective To pursue explanations for compromised efficacy and induction of side-effects in some generic brands of lamotrigine distributed in Australia. Method Bioassays of the non-generic and five generic lamotrigine tablets were undertaken (also after exposure to heat and cold), as well as assays of two generic drugs generating concerning side-effects in two patients, while enquiries were made of manufacturing companies. Results Mass spectrometry of the six tested products showed comparable properties and no compromising when those tablets were heated and cooled, while analyses of the products taken by the two patients reporting significant side-effects showed an increase in the peak area lamotrigine concentration. Conclusions We failed to identify any intrinsically compromised product in our comparison analyses of the six preparations. We consider alternate explanations for an issue leading to widespread international reporting of distinct side-effects and deaths following brand switching, with analyses of the two problematic preparations supporting a ‘faulty’ batch explanation.

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confidence: 98%