Lamictal Reaction Alert!
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Q:  Lamictal Reaction  Alert!

LAMICTAL REACTION with severe sunburn, dry eyes, "flaking" but not peeling skin, chapped lips, severe headache, severe neck ache and back ache. Sunburned skin began at 50mg bid.  Not recognized initially as I have flushing with roseacea.  Also at times have ocular roseacea with very irritated eyes.  Never had "rashiness",  never had "peeling" but skin became sandpapery rough, forehead flaky, redness of face, neck, upper ant. chest became more and more prominent.    At 125mg bid neck pain became prominant (explained away as fibromyalgia acting up.  At 150mg bid headache was severe.  I do not get headache. This sx triggered the this is NOT OK reaction.
Really paying attention to the pain details - there were NO tender points with this pain.  With fibromyalgia flares tender points are the rule for me as expected if dx is fibromyalgia.

With every dosage increase psychiatrist asked do you have rash, do you have peeling.   I always have slightly more flush than most folks, and roseacea waxes and wains.  Am erratic with Metragel (and would probably do better with TCN but get itching from TCN/doxy/minoc.

We started Lamictal reluctantly because I have rash hx to TCN family, propranolol, and allergic to chloramphenicol (1959). 

Using sunburn as well as rash for question is important I suggest, as I finally found some description that described common presentation as mild to severe sunburn or rash. ???PAIN HAS BEEN THE MOST PROMINANT SX -Obviously had we recognized sunburn=rash we would have stopped the Lamictal at 50bid.  Have you seen pain as prominant component?  Any experience with Lamictal rash.  Neither my neurologist nor my psychiatrist (nor me nor my MD husband) had seen "lamictal rash" so trying to get info. Do you know any resources (I have a call in to Jos. Calabrese in Cleveland who probably has most research experience with Lamictal, he is on vacation until 8/12)

Dear Ms. L' 
Thanks for your description of your reaction to Lamictal.  I hope posting this one will help others who find themselves with similar symptoms.  For anyone contemplating Lamictal, please note that this reaction is so uncommon that it warrants posting as an alert -- because the skin reaction you'll hear about with this medication is not this!  

The common skin reaction, as long as it does not involve the mouth area or make you physically sick (a reaction that now occurs in 1/3000 people or less), is not dangerous as long as it is handled properly (we used to just stop; now, following the guide of people like Dr. Calabrese and Lauren Marengell in Texas, the expert recommendation is to lower the dose and wait until the symptoms disappear, then resume dose increases).  

By contrast, this reaction is so unusual that I have no recommendations, as I have no experience with it.  By this time I hope you've heard back from Dr. Calabrese; or that you could have your provider try to contact him. 

Dr. Phelps

Published September, 2002 


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