Dear Colleagues:

Several weeks ago I posted a notice of warning concerning the use of
Lamotrigine(Lamictal) in breastfeeding women. It concerned the rather high
incidence of Stevens-Johnson syndrome in children using this product (one in
fifteen). It was apparently posted by the Glaxo company who makes the
product.

After discussing this with my colleague Frank Nice, his sources at the FDA
suggest that the true incidence of dangerous rashes is probably much less
around 0.5%  and that this may be dose related, only occurring at higher
doses(>3mg/kg).  Fortunately, the published levels in milk would only
provide about 2-5 mg per day to the infant which is probably far too low to
induce this syndrome.

It is their contention(FDA), that the dose in milk would not approach this
high dose, and I concur.

While I think we should be somewhat cautious using Lamotrigine in
breastfeeding women, always observing for rashs,  I concur with their
suggestion that the risk of Stevens Johnson syndrome is probably less
probable than I was led to believe.  So I stand corrected.

Thanks to Frank for his help on this matter.

Regards

Tom Hale, Ph.D.

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