Which antiepileptic drug can cause Stevens-Johnson syndrome?

Stevens-Johnson syndrome (SJS) is a serious skin reaction that can lead to severe health complications, and certain medications are known to increase the risk of developing this condition. Lamotrigine is particularly associated with SJS, especially when dose escalation is rapid or when it is used in combination with valproate, which can increase its levels in the bloodstream.

The mechanism behind lamotrigine causing SJS is thought to involve an immune-mediated reaction leading to the detachment of the epidermis from the dermis, resulting in painful skin lesions. This risk necessitates careful monitoring when initiating therapy or adjusting the dosage, particularly in patients with a history of drug-induced skin reactions.

While other drugs such as carbamazepine can also cause cutaneous reactions, lamotrigine is notably recognized for its potential to lead to Stevens-Johnson syndrome when not managed correctly during titration. This highlights the importance of dosing guidelines and patient education regarding signs of skin reactions while on lamotrigine therapy.