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It has long been known that the “aromatic” anticonvulsants (phenobarbital, phenytoin, and carbamazepine) have a high rate of cross-reactivity for severe adverse cutaneous reactions. In addition, researchers have observed similar eruptions in lamotrigine recipients. The reaction rate for other antiepileptic agents has not been well studied. Two groups of researchers recently examined this issue in large cohorts.
Alvestad and colleagues reviewed the experience of 1875 outpatients taking 15 of the most commonly prescribed antiepileptic agents. They analyzed the frequency of observed or self-reported rashes, as well as other features of anticonvulsant hypersensitivity syndrome (a drug reaction involving eosinophilia and systemic symptoms, includ…