A Case Report: Lamotrigine Induced Steven Johnson Syndrome

Abstract

A 21 years old male with complaints of erythematous erosive lesions, itchy and burning sensation all over the body for 5 days and multiple erythematous maculopapular lesions on palms and soles, erosive mucosal lesions in oral mucosa, erosive erythematous lesions on the scrotum, discharge from the eye, blurring of vision and redness in both the eyes. The patient was evaluated by three local doctors but not fully diagnosed. The lesions started after taking antidepressant selective serotonin reuptake inhibitor (SSRI’S) which was Lamotrigine, along with this Aripiprazole-Atypical antidepressant and Desfenlafaxine-a serotonin and norepinephrine reuptake inhibitor (SNRI’S) was taken, it was prescribed by a psychologist who thought the patient is depressed, but the patient was inactive due to anemia. The initial dose of Lamotrigine is 25mg per day which can be managed further based on symptoms, but the patient was directly started with 100mg half tablet for 8days along with one 200mg of lamotrigine at night. The patient was not made aware of drug-related information like it’s side effects, improper drug usage and what if dose is missed. After taking patient history and examination the diagnosis was made to be Lamotrigine induced Steven Johnson syndrome (SJS). The patient was not depressed and he was not active as he was anemic. After correct diagnosis, the management was done with a corticosteroid, antihistamines, Pantoprazole, and antibiotic along with mouthwash and eye drops. The recovery period was of 40 days.