Targeted blood tests, asking patients about risk factors, and dose modifications can lessen the risk of potentially fatal reactions to antiseizure medications that millions of Americans take for epilepsy and other conditions. However, skin reactions in newly medicated patients still require speedy medical attention, according to research from Rutgers Health.
Rashes are a common side effect of antiseizure medications, occurring in 2 to 16 percent of patients and vary by specific drug.
Although most rashes are not life-threatening, roughly 5 percent indicate life-threatening reactions. The FDA recently issued a warning about serious reactions to two antiseizure medications: levetiracetam and clobazam.
Despite these risks, antiseizure medicines are important for many medical conditions. The proper antiseizure medication can stop further seizures in 70 percent of patients. Such medications also help many patients with bipolar disorder, anxiety, migraines and neuropathic pain.
This new review synthesizes published data on individual antiseizure medications and distinguishes the different rashes and their triggers.
Risk factors for severe reactions include the use of aromatic antiseizure medications, rapid dose escalation, genetic predisposition, and certain drug interactions.
The most common non-disabling reaction is a rash that typically occurs within two weeks of treatment. It typically affects the torso or limbs with a flat rash or hive-like bumps. It usually disappears without treatment a few weeks after patients stop the medication.
Severe conditions, on the other hand, often require urgent treatment. In Stevens-Johnson syndrome or toxic epidermal necrolysis — which produces fever, eye pain and detached skin — inpatient care is often needed.
Ram Mani estimated that several thousand patients suffer severe reactions to antiseizure medications each year, but the numbers could decrease if neurologists consistently put high-risk patients on low-risk medicines.
