Lamotrigine
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Various toxicities: 6 case reports In a study on patients with epilepsy, three men were identified who developed adverse effects after their established lamotrigine therapy was changed from Lamictal to generic products.* Additionally, lamotrigine was associated with tremor or double vision in three men with focal epilepsy in the control group [duration of treatments, routes and frequencies of administration, and outcomes not stated]. A 41-year-old man with a history of severe psoriasis experienced massive worsening of his skin changes a few days after Lamictal 450mg was replaced with Lamotrigin Atid 450mg. An 86-year-old man experienced intolerable vertigo with nausea after his therapy with Lamictal 300mg was switched to Lamotrigin Desitin 300/250mg [time to onset not stated]; following the switch, his serum lamotrigine concentration increased from 6.2 mg/L to 6.7 mg/L. A 70-year-old man’s treatment with Lamictal 400mg was switched to Lamotrigin Atid 400mg with a 40% increase in serum lamotrigine concentrations (6.3 to 8.1 mg/L). He also developed intoxication symptoms such as highly frequent positional tremor and ataxic gait [time to onset not stated]. Symptoms culminated in a fall, during which he contracted contusions on his shoulder and skull, and required hospitalisation. A 59-year-old man, who was receiving Lamictal 125mg, presented with persistent mild tremor on all three appointments during the study period [time to onset not stated]. A 69-year-old man had developed new-onset tremor while receiving Lamictal 300mg at the time of the last appointment during the study period [time to onset not stated]; he considered the reaction hardly limiting. A 44-year-old man, who was receiving Lamotrigin Hexal 225mg, presented with new-onset of rare double vision for the last appointment during the study period [time to onset not stated]; he considered the reaction hardly limiting. * Another ten patients switched between different lamotrigine products without side effects; however, some patients did experience differences in seizure frequency. Carius A, et al. Changing lamotrigine preparations in epilepsy patients. Experiences of a university epilepsy outpatient centre. Nervenarzt 81: 423-434, No. 4, Apr 2010. Available from: URL: http://dx.doi.org/10.1007/s00115-010-2933-8 803029743 [German] - Germany
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Reactions 31 Jul 2010 No. 1312
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