From the Research
Lamictal (lamotrigine) can rarely cause leukopenia, which is a decrease in white blood cell count, and patients taking this medication should have regular blood work monitoring to detect this potentially serious side effect. This recommendation is based on the most recent and highest quality study available, which reported a case of Stevens-Johnson syndrome and neutropenia associated with lamotrigine use 1. The study highlights the importance of monitoring white blood cell count in patients taking lamotrigine, especially if they develop fever, sore throat, or other signs of infection.
Some key points to consider when prescribing lamotrigine include:
- Baseline blood work should be done before starting treatment
- Periodic monitoring of white blood cell count during therapy is essential
- Patients should be educated about the symptoms of leukopenia, such as signs of infection, unusual bleeding or bruising, or excessive fatigue
- Healthcare providers should weigh the benefits of continuing lamotrigine against the risks of leukopenia in each individual case
Other studies have also reported cases of leukopenia and thrombocytopenia associated with lamotrigine use 2, 3, highlighting the need for careful monitoring of patients taking this medication. However, the most recent and highest quality study 1 provides the strongest evidence for the recommendation to monitor white blood cell count in patients taking lamotrigine.
In terms of the mechanism behind lamotrigine-induced leukopenia, it is thought to be immune-mediated, possibly involving direct toxicity to white blood cell precursors or an immune response against white blood cells. However, the exact mechanism is not fully understood and requires further study.
Overall, the available evidence suggests that lamotrigine can cause leukopenia, and patients taking this medication should be closely monitored to detect this potentially serious side effect. Regular blood work monitoring is essential to minimize the risk of leukopenia and ensure the safe use of lamotrigine.