Lamotrigine-induced common variable immune deficiency

Abstract

The antiepileptic agents phenytoin and carbamazepine have been associated with decreased immunoglobulin levels.1 We report a case of reversible hypogammaglobulinemia associated with use of the newer antiepileptic agent lamotrigine. Lamotrigine acts mainly by inhibiting glutamate release through sodium channel blockade and thus stabilizes neuronal membranes.2 It is not related to other anticonvulsant agents. The most commonly reported adverse effects during lamotrigine monotherapy are dizziness, somnolence, nausea, asthenia, and headache.3 Skin rashes and dizziness were the most frequent adverse effect requiring withdrawal in a review of safety data on lamotrigine from clinical trial managed by the manufacturer up to 1998.4 A 59-year-old man was treated with lamotrigine in October 1999 after recurrent episodes of prolonged amnesia thought to result from epilepsy. He had a long history of primary generalized epilepsy and had been …