Stevens-Johnson Syndrome while on lamotrigine and NSAID:A case report

Madhavi  Bhat; Anil  Kakunje; Rajesh  Mithur; M Manjunath  Shenoy; K A  Mashood; Sowmya Puthran; Anjana  Joy

doi:10.30834/KJP.34.1.2021.249

Authors

Madhavi Bhat Junior Resident, Department of Psychiatry, Yenepoya Medical College, Mangalore
Anil Kakunje Professor & Head, Dept of Psychiatry, Yenepoya Medical College, Yenepoya deemed to be University, Mangalore, India
Rajesh Mithur Senior Resident, Dept of Psychiatry, Yenepoya Medical College, Yenepoya deemed to be University, Mangalore. India
M Manjunath Shenoy Professor of Dermatology, Yenepoya Medical College, Yenepoya deemed to be University, Mangalore. India
K A Mashood Senior Resident, Department of Geriatric Medicine, Yenepoya Medical College, Yenepoya deemed to be University, Mangalore, India
Sowmya Puthran Psychologist, Dept of Psychiatry, Yenepoya Nursing Home, Kankanady, Mangalore
Anjana Joy PSW, Psychiatry Rehabilitation, Dept of Psychiatry, Yenepoya Nursing Home, Kankanady, Mangalore

DOI:

https://doi.org/10.30834/KJP.34.1.2021.249

Keywords:

Bipolar depression, Stevens – Johnson syndrome, Lamotrigine, Sodium Valproate, NSAID

Abstract

Stevens-Johnson syndrome is a severe immune-mediated cutaneous reaction occurring due to exposure to certain drugs. Lamotrigine is an FDA approved drug used in the treatment of bipolar depression. When it is given concomitantly with sodium valproate, the risk of developing Stevens-Johnson syndrome increases. Here we present the report of a patient with bipolar depression who developed serious skin rashes while on lamotrigine and NSAID prescribed by a local doctor, who recovered after timely management. This case highlights the importance of following proper dosing, drug escalation regimen and managing drug interactions during lamotrigine therapy.

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