Toxic epidermal necrolysis (TEN) is a severe skin disorder often triggered by drug reactions, with Lamotrigine being a common culprit, especially when used at high doses or with rapid titration. This case study details a 20-year-old woman with bipolar II disorder who developed TEN after being prescribed Lamotrigine for a depressive episode. She experienced severe skin detachment and mucosal involvement, requiring intensive treatment. This highlights the need for caution when prescribing Lamotrigine, especially in adolescents, and the importance of gradual titration and close monitoring.

The patient’s TEN was linked to inappropriate dosage and rapid Lamotrigine titration, which increases the risk of severe adverse reactions. While Lamotrigine is effective for preventing bipolar depression relapse, this case emphasizes the importance of careful diagnosis and pharmacological decisions in adolescents. It also underscores the need for patient and family education about the risks of Lamotrigine and the necessity of strict follow-up to prevent serious complications like TEN.

Reference: Claude N, Belmar M, Parada B. Toxic epidermal necrolysis in an adolescent diagnosed with bipolar disorder II and treated with Lamotrigine. Journal of Neuroeuropsychiatry. Accessed February 17, 2025. https://www.journalofneuropsychiatry.cl/articulo.php?id=60