Table of ContentsView AllTable of ContentsRash SymptomsHypersensitivity ReactionsCausesTreatmentFrequently Asked Questions

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Table of Contents

Rash Symptoms

Hypersensitivity Reactions

Causes

Treatment

Frequently Asked Questions

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Since its introduction in 1994, the medication has enjoyed widespread use. Today, it is on the World Health Organization’s List of Essential Medications.

If you experience a rash while taking Lamictal, see your doctor immediately. If it is spreading quickly, call 911 or go to your nearest emergency room. It is far better to be safe than sorry, no matter how​ low the risk may be.

Symptoms of Lamictal Rash

There are a number of early-onset symptoms that might indicate that you are having an allergic reaction to Lamictal. Some of these include:

Warning:Symptoms of a more serious rash can include peeling skin, painful blisters, inflammation of the eyes, swollen lymph nodes, and flu-like symptoms.

Warning:

Symptoms of a more serious rash can include peeling skin, painful blisters, inflammation of the eyes, swollen lymph nodes, and flu-like symptoms.

The symptoms can range from benign to potentially fatal. However, there is no way to gauge the potential outcome based on the symptoms. If you experience any signs of a rash when taking Lamictal, even if it seems mild, you need to contact your doctor immediately.

The FDA warns that people who take Lamictal may experience a number of hypersensitivity reactions.A hypersensitive reaction occurs when a condition or drug causes the immune system to overreact, resulting in an allergy or adverse autoimmune response.

With Lamictal, these can include reactions known as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reactions with eosinophilia and systemic symptoms (DRESS syndrome).

Each of these conditions manifests with a severe (some say “angry”) rash, which typically develops after two to eight weeks of drug use. Mortality rates are significant, ranging from 5% to as high as 30%.

Stevens-Johnson Syndrome

The skin rash can be incredibly painful and, in some cases, lead to the detachment and shedding of skin.

Toxic Epidermal Necrolysis

Toxic epidermal necrolysis (TEN) is essentially SJS but worse. TEN involves the detachment of more than 30% of skin, as opposed to SJS, which involves less than 10%.Moreover, the risk of death from TEN is between four and five times greater than that from SJS.

DRESS Syndrome

DRESS syndrome is a drug reaction that can also cause rash alongside other characteristic symptoms, including severe nerve pain and inflammation of at least one major organ (most often the liver, kidneys, lungs, heart, muscles, or pancreas).

Causes of Hypersensitivity

By and large, people under age 17 are more likely to have a reaction to Lamictal than adults. In addition, several factors can increase the likelihood of an adverse response:

It should be pointed out, however, that hypersensitivity can sometimes occur even if you are taking the drug as prescribed. While genetic factors appear to play a part,the causes are occasionally idiopathic (meaning we simply don’t know the reason).

According to the FDA’s research, there is about a three-fold increase in risk if you take Lamictal as compared to other mood stabilizers. If you are under 16, the risk will further double.

It is important to note, however, that not all hypersensitivity reactions will result in SJS. Putting it all into perspective, there is only a 0.1% chance of such an event occurring.

In the end, the severity of the reaction, as well as the availability of other mood-stabilizing drugs, informed the FDA decision as much as the statistical risk itself.

Treatment for Lamictal Rash

Treatment involves the immediate discontinuation of Lamictal and using supportive therapies to treat the pain, prevent infection, and ensure that the person remains properly hydrated.

The skin damage is treated in a similar manner to a thermal burn. Corticosteroids are commonly used to reduce inflammation.

If a person is required to stop taking Lamictal, their doctor may recommend a different mood stabilizer such as Depakote (divalproex sodium, sodium valproate, and valproic acid),lithium, or Topamax (topiramate). Research also suggests that Zyprexa (olanzapine) can help manage symptoms of bipolar disorder.

Two strategies that can prevent serious Lamictal rashes include titration (which involves starting at a low dose and gradually increasing the amount) and stopping the medication if any symptoms of skin rashes appear within the first two months of treatment.

A Lamictal rash typically appears within five days to eight weeks of initiating treatment and usually disappears within a few days after stopping the medication.

10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.WHO model lists of essential medications.U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA warns of serious immune system reaction with seizure and mental health medicine lamotrigine (Lamictal).GlaxoSmithKline.Lamictal (lamotrigine): Highlights of prescribing information. GSK; 2014.Wang XQ, Lv B, Wang HF, et al.Lamotrigine-induced severe cutaneous adverse reaction: Update data from 1999-2014.J Clin Neurosci. 2015;22(6):1005-1011. doi:10.1016/j.jocn.2015.01.016Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T.Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis.Clin Rev Allergy Immunol. 2018;54(1):147-176. doi:10.1007/s12016-017-8654-zWang XQ, Lv B, Wang HF, et al.Lamotrigine induced DIHS/DRESS: Manifestations, treatment, and outcome in 57 patients.Clin Neurol Neurosurg. 2015;138:1-7. doi:10.1016/j.clineuro.2015.07.008Provenzani A, Labbozzetta M, Notarbartolo M, et al.Rash and multiorgan dysfunction following lamotrigine: Could genetic be involved?Int J Clin Pharm. 2015;37(5):682-686. doi:10.1007/s11096-015-0158-4Pan PY, Lee MS, Lo MC, Yang EL, Yeh CB.Olanzapine is superior to lamotrigine in the prevention of bipolar depression: A naturalistic observational study.BMC Psychiatry. 2014;14:145. doi:10.1186/1471-244X-14-145Aiken C.How to minimize lamotrigine’s adverse effects.Psychiatric Times; 2018.Kverno K, Beauvois L, Dudley-Brown S.Lamotrigine rash: Benign allergy or severe adverse reaction?The Nurse Practitioner. 2018;43(3):48-51. doi:10.1097/01.NPR.0000530211.32278.96

10 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.WHO model lists of essential medications.U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA warns of serious immune system reaction with seizure and mental health medicine lamotrigine (Lamictal).GlaxoSmithKline.Lamictal (lamotrigine): Highlights of prescribing information. GSK; 2014.Wang XQ, Lv B, Wang HF, et al.Lamotrigine-induced severe cutaneous adverse reaction: Update data from 1999-2014.J Clin Neurosci. 2015;22(6):1005-1011. doi:10.1016/j.jocn.2015.01.016Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T.Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis.Clin Rev Allergy Immunol. 2018;54(1):147-176. doi:10.1007/s12016-017-8654-zWang XQ, Lv B, Wang HF, et al.Lamotrigine induced DIHS/DRESS: Manifestations, treatment, and outcome in 57 patients.Clin Neurol Neurosurg. 2015;138:1-7. doi:10.1016/j.clineuro.2015.07.008Provenzani A, Labbozzetta M, Notarbartolo M, et al.Rash and multiorgan dysfunction following lamotrigine: Could genetic be involved?Int J Clin Pharm. 2015;37(5):682-686. doi:10.1007/s11096-015-0158-4Pan PY, Lee MS, Lo MC, Yang EL, Yeh CB.Olanzapine is superior to lamotrigine in the prevention of bipolar depression: A naturalistic observational study.BMC Psychiatry. 2014;14:145. doi:10.1186/1471-244X-14-145Aiken C.How to minimize lamotrigine’s adverse effects.Psychiatric Times; 2018.Kverno K, Beauvois L, Dudley-Brown S.Lamotrigine rash: Benign allergy or severe adverse reaction?The Nurse Practitioner. 2018;43(3):48-51. doi:10.1097/01.NPR.0000530211.32278.96

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

World Health Organization.WHO model lists of essential medications.U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA warns of serious immune system reaction with seizure and mental health medicine lamotrigine (Lamictal).GlaxoSmithKline.Lamictal (lamotrigine): Highlights of prescribing information. GSK; 2014.Wang XQ, Lv B, Wang HF, et al.Lamotrigine-induced severe cutaneous adverse reaction: Update data from 1999-2014.J Clin Neurosci. 2015;22(6):1005-1011. doi:10.1016/j.jocn.2015.01.016Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T.Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis.Clin Rev Allergy Immunol. 2018;54(1):147-176. doi:10.1007/s12016-017-8654-zWang XQ, Lv B, Wang HF, et al.Lamotrigine induced DIHS/DRESS: Manifestations, treatment, and outcome in 57 patients.Clin Neurol Neurosurg. 2015;138:1-7. doi:10.1016/j.clineuro.2015.07.008Provenzani A, Labbozzetta M, Notarbartolo M, et al.Rash and multiorgan dysfunction following lamotrigine: Could genetic be involved?Int J Clin Pharm. 2015;37(5):682-686. doi:10.1007/s11096-015-0158-4Pan PY, Lee MS, Lo MC, Yang EL, Yeh CB.Olanzapine is superior to lamotrigine in the prevention of bipolar depression: A naturalistic observational study.BMC Psychiatry. 2014;14:145. doi:10.1186/1471-244X-14-145Aiken C.How to minimize lamotrigine’s adverse effects.Psychiatric Times; 2018.Kverno K, Beauvois L, Dudley-Brown S.Lamotrigine rash: Benign allergy or severe adverse reaction?The Nurse Practitioner. 2018;43(3):48-51. doi:10.1097/01.NPR.0000530211.32278.96

World Health Organization.WHO model lists of essential medications.

U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA warns of serious immune system reaction with seizure and mental health medicine lamotrigine (Lamictal).

GlaxoSmithKline.Lamictal (lamotrigine): Highlights of prescribing information. GSK; 2014.

Wang XQ, Lv B, Wang HF, et al.Lamotrigine-induced severe cutaneous adverse reaction: Update data from 1999-2014.J Clin Neurosci. 2015;22(6):1005-1011. doi:10.1016/j.jocn.2015.01.016

Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T.Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis.Clin Rev Allergy Immunol. 2018;54(1):147-176. doi:10.1007/s12016-017-8654-z

Wang XQ, Lv B, Wang HF, et al.Lamotrigine induced DIHS/DRESS: Manifestations, treatment, and outcome in 57 patients.Clin Neurol Neurosurg. 2015;138:1-7. doi:10.1016/j.clineuro.2015.07.008

Provenzani A, Labbozzetta M, Notarbartolo M, et al.Rash and multiorgan dysfunction following lamotrigine: Could genetic be involved?Int J Clin Pharm. 2015;37(5):682-686. doi:10.1007/s11096-015-0158-4

Pan PY, Lee MS, Lo MC, Yang EL, Yeh CB.Olanzapine is superior to lamotrigine in the prevention of bipolar depression: A naturalistic observational study.BMC Psychiatry. 2014;14:145. doi:10.1186/1471-244X-14-145

Aiken C.How to minimize lamotrigine’s adverse effects.Psychiatric Times; 2018.

Kverno K, Beauvois L, Dudley-Brown S.Lamotrigine rash: Benign allergy or severe adverse reaction?The Nurse Practitioner. 2018;43(3):48-51. doi:10.1097/01.NPR.0000530211.32278.96

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