Lamictal (lamotrigine) is a drug prescribed to treat seizures and bipolar disorder. The drug has been linked to severe side effects including:

• Stevens Johnson Syndrome (SJS)
• Toxic Epidermal Necrolysis (TEN)
• Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
• Drug-Induced Hypersensitivity Syndrome (DIHS)
• Hemophagocytic Lymphohistiocytosis (HLH)

Some of these side effects of Lamictal can be deadly. When these conditions develop as a result of Lamictal use, they are often accompanied by a Lamictal rash. Patients who took Lamictal and developed a rash may be showing early signs of more serious symptoms like the ones listed above.

Lamictal Side Effects

One of the serious side effects of Lamictal is hemophagocytic lymphohistiocytosis (HLH). In this condition, the body produces too many immune cells. Though this can be inherited, it can be acquired through non-genetic means.

When the condition develops later in life, and not as a result of genetics, it can develop as a response to infection, or as an adverse reaction to some medication, as is the case when it develops in conjunction with Lamictal use.

Symptoms of hemophagocytic lymphohistiocytosis (HLH) include:

• Enlarged liver—symptoms may include pain, tenderness, or unusual swelling over the liver area in the upper right belly
• Fever
• Nervous system problems—including seizures, trouble walking, difficulty seeing, or other visual disturbances
• Skin rash
• Swollen lymph nodes
• Unusual bleeding
• Yellow skin or eyes

Patients may develop HLH as a side effect of Lamictal without realizing it. The Food and Drug Administration warns that this condition can be often confused with other side effects of Lamictal, including drug reaction with eosinophilia and systemic symptoms, or DRESS syndrome.

Typically, a hemophagocytic lymphohistiocytosis diagnosis comes after a person who took Lamictal exhibits at least five of the following symptoms:

• Cytopenias
• Decreased or absent Natural Killer (NK) Cell activity
• Elevated blood levels of CD25 showing prolonged immune cell activation
• Elevated levels of triglycerides or low blood levels of fibrinogen
• Enlarged spleen
• Fever and rash
• Hemophagocytosis identified through bone marrow, spleen, or lymph node biopsy
• High levels of blood ferritin

Because of the seriousness of hemophagocytic lymphohistiocytosis, the Food and Drug Administration issued a safety warning in 2018 warning patients that Lamictal has been linked to the disease. As a result of this announcement, Lamictal maker GlaxoSmithKline was required to include the warning of the disease on Lamictal’s label and accompanying information.

Though there is now a warning for HLH with Lamictal, many patients did not know of the possible side effects before taking the drug. In many cases in which serious drug side effects are discovered, drug companies can be held accountable legally. Patients may have a legal claim if they can show that Lamictal’s manufacturer failed to issue a proper warning about the drug’s possible side effects.