A Rash Decision with Antiepileptic Drugs

Although the development of a rash with use of antiepileptic drugs (AEDs) is common and usually benign, it can, rarely, be severe. The risk for Stevens-Johnson syndrome (SJS) with the use of lamotrigine is the major obstacle to rapid administration of therapeutic dosages. Thus, any information that helps to predict which patients are at risk would be useful. These authors retrospectively reviewed the charts of 1649 adult AED recipients (age, ≥16) who were seen at a large epilepsy center. Fifteen AEDs, both older and newer types, were included.

The average rate of AED-related rash for all drugs was 2.8%. In univariate analysis, there were several nondrug predictors of rash (e.g., another AED rash, non-AED allergy, atrial fibrillation, female …