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Hemaphagocytic lymphohistiocytosis (HLH) has occurred in patients taking Lamotrigine (see Side effect). HLH is a syndrome is a pathological immune activation, which can be life threatening, characterized by clinical signs and symptoms such as fever, rash, neurological symptoms, hepatosplenomegaly, lymphadenopathy, cytopenias, high serum ferritin, hypertriglyceridemia and abnormalities of liver function and coagulation. Symptoms occur generally within 4 weeks of treatment initiation. Immediately evaluate patients who develop these signs and symptoms and consider a diagnosis of HLH. Lamotrigine should be discontinued unless an alternative etiology can be established.
Brugada-type ECG: A very rare association with Brugada-type ECG may be observed, although a casual relations hip has not been established. Therefore careful consideration should be given before using Lamotrigine in patients with Brugada syndrome.
