Table 2.
Case series of lamotrigine rechallenge
| Subject | Diagnosis | Age | Sex | Onset of Rash (wks) | Description of Rash | Severity Rating | Interval Between Discontinuation and Rechallenge (wks) | Follow-up Since Rechallenge (wks) | Outcome | CGI Improvement | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Bipolar NOS | 27 | F | 3 | Symmetric morbilliform rash of chest, pruritic and blanching | 0 | 11 | 230 | Successful | 0 | |
| 2 | Bipolar II depression | 42 | F | 1 | Macules and wheals on face and back | 1 | 11 | 230 | Successful | 1 | |
| 3 | Bipolar I depression | 31 | F | 22 | Macular facial rash | 1 | 79 | 228 | Successful | 1 | |
| 4 | Bipolar I, mixed state, rapid cycling | 25 | F | 1 | Macular facial rash | 1 | 76 | 226 | Successful | 2 | |
| 5 | Bipolar NOS | 34 | F | 2 | Vesicles on tongue | 1 | 97 | 224 | Successful | 3 | |
| 6 | Bipolar II depression | 41 | F | 1 | Erythematous pruritic wheals on arms and tongue | 2 | 6 | 223 | Successful | 1 | |
| 7 | Bipolar II depression | 32 | F | 2 | Blanching pruritic macules on face and neck | 1 | 19 | 219 | Successful | 1 | |
| 8 | Bipolar II depression | 42 | F | 2 | Tender vesicles on lip | 2 | 10 | 214 | Successful | 1 | |
| 9 | Bipolar I depression, rapid cycling | 20 | F | 3 | Morbilliform rash, generalized | 1 | 11 | 213 | Successful | 1 | |
| 10 | Bipolar due to a general medical condition (frontal lobe infarct) | 19 | M | - | Unknown (lamotrigine had been stopped 11 years prior to the study due to a rash) | - | 520 (approximately) | 177 | Successful | 4 | |
| 11 | Cyclothymia | 44 | F | 4 | Wheals on legs, 3 blistering papules on knuckles | 1 | 7 | 177 | Successful | 2 | |
| 12 | Bipolar II depression | 44 | M | 6 | Macular rash on chest and extremities with fever | 1 | 5 | 171 | Successful | 3 | |
| 13 | Schizoaffective, bipolar type, rapid cycling | 26 | F | 7 | Wheals and macules on lips, tongue and arm; edema on legs | 2 | 4 | 165 | Successful | 2 | |
| 14 | Bipolar I depression | 22 | F | 1 | Pruritic erythema on extremities | 0 | 10 | 150 | Successful | 3 | |
| 15* | Bipolar II depression | 47 | F | 4 | Patch and papules on abdomen, pruritic | 0 | 3 | 136 | Successful | 1 | |
| 16 | Bipolar II depression | 55 | F | 12 | White vesicles on mouth | 1 | 1 | 124 | Successful | 2 | |
| 17 | Bipolar NOS | 45 | M | 2 | Pruritic vesicles on arms and chest | 0 | 19 | 110 | Successful | 3 | |
| 18 | Bipolar II depression | 22 | F | 5 | Urticaria on neck | 1 | 49 | 80 | Successful | 2 | |
| 19 | Bipolar II depression | 20 | F | 5 | Perioral papules and dry patches on face, pruritic | 1 | 6 | 47 | Successful | 2 | |
| 20 | Bipolar II depression | 40 | M | 12 | Blistering vesicles on mouth | 2 | 7 | 13 | Successful | 2 | |
| 21 | Bipolar II depression | 20 | M | 3 | Diffuse petichial rash on abdomen, chest, back, legs and face; lymphadenopathy | 2 | 4 | 16 | Successful | 1 | |
| 22 | Bipolar I depression | 46 | M | 9 | Tender, raised papules on legs | 1 | 41 | 14 | Successful | 2 | |
| 23 | Bipolar NOS | 19 | M | 5 | Pruritis on face, sore throat, malaise | 2 | 13 | 13 | Fever, malaise, headache (no rash) | 0 | |
| 24 | Bipolar II depression | 37 | F | 4 | Vesicles in mouth | 1 | 4 | 300 | Mild erythema of bilateral arms | 2 | |
| 25* | Bipolar I depression | 53 | M | 1 | 2 | raised erythematous patches on face and neck | 1 | 1 | 160 | Benign fixed drug eruption | 3 |
| 26 | Bipolar I depression | 17 | F | 3 | Pruritic, tender erythema on back | 1 | 2 | 50 | Painful erythema with dyspnea, neuralgia | 3 | |
| 27 | Bipolar II depression | 23 | M | 5 | Throat blisters, malaise, fever, shoulder erythema, eosinophilia (5.6%) | 4 | 4 | 11 | Nonblistering erythematous vesicles on shoulder and face | 1 |
*
In these cases the patient mistakenly raised lamotrigine every week instead of every 2 weeks
CGI = Clinical Global Impression