Abstract
Lamotrigine and nonaromatic antiepileptic drugs (valproate, gabapentin, and topiramate) are associated with hypersensitivity reactions, mainly cutaneous eruptions. The underlying mechanisms of these manifestations are not yet completely understood. A cell-mediated pathogenic mechanism has been demonstrated in some cases on the basis of positive patch tests and/or lymphocyte transformation tests. Moreover, an in vitro lymphocyte toxicity assay, which exposes the patients lymphocytes to arene oxides, has detected lymphocyte susceptibility to toxic metabolites in patients with hypersensitivity reactions to lamotrigine. Subjects with a history of mild hypersensitivity reactions and negative allergologic tests can be challenged with the suspected drugs. Challenge tests can also be useful to identify safe alternatives. Our study reports hypersensitivity reactions to lamotrigine and to nonaromatic antiepileptic drugs, especially those assessed by allergologic tests.
Keywords: Lamotrigine, valproate, gabapentin, topiramate, aromatic anticonvulsant, nonaromatic anticonvulsant, hypersensitivity, cutaneous adverse reactions
Current Pharmaceutical Design
Title: Hypersensitivity to Lamotrigine and Nonaromatic Anticonvulsant Drugs: A Review
Volume: 14 Issue: 27
Author(s): Francesco Gaeta, Cristiana Alonzi, Rocco Luigi Valluzzi, Marinella Viola, Maurizio Elia and Antonino Romano
Affiliation:
Keywords: Lamotrigine, valproate, gabapentin, topiramate, aromatic anticonvulsant, nonaromatic anticonvulsant, hypersensitivity, cutaneous adverse reactions
Abstract: Lamotrigine and nonaromatic antiepileptic drugs (valproate, gabapentin, and topiramate) are associated with hypersensitivity reactions, mainly cutaneous eruptions. The underlying mechanisms of these manifestations are not yet completely understood. A cell-mediated pathogenic mechanism has been demonstrated in some cases on the basis of positive patch tests and/or lymphocyte transformation tests. Moreover, an in vitro lymphocyte toxicity assay, which exposes the patients lymphocytes to arene oxides, has detected lymphocyte susceptibility to toxic metabolites in patients with hypersensitivity reactions to lamotrigine. Subjects with a history of mild hypersensitivity reactions and negative allergologic tests can be challenged with the suspected drugs. Challenge tests can also be useful to identify safe alternatives. Our study reports hypersensitivity reactions to lamotrigine and to nonaromatic antiepileptic drugs, especially those assessed by allergologic tests.
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Cite this article as:
Gaeta Francesco, Alonzi Cristiana, Valluzzi Luigi Rocco, Viola Marinella, Elia Maurizio and Romano Antonino, Hypersensitivity to Lamotrigine and Nonaromatic Anticonvulsant Drugs: A Review, Current Pharmaceutical Design 2008; 14 (27) . https://dx.doi.org/10.2174/138161208786369713
DOI https://dx.doi.org/10.2174/138161208786369713 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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