What serious skin reaction should be monitored when prescribing Lamotrigine?

When prescribing Lamotrigine, it is crucial to monitor for the development of serious skin reactions, particularly Stevens-Johnson syndrome (SJS). Lamotrigine is known to be associated with this condition, especially if the medication is titrated too quickly or in patients who are also taking valproate. SJS is a severe and potentially life-threatening condition characterized by extensive skin necrosis and blistering, which can lead to complications such as infection and multi-organ failure.

The importance of vigilance regarding this reaction lies in its rapid onset and severity, making early recognition and intervention critical. Monitoring patients, especially during the initial phase of treatment and when increasing the dosage, allows for timely identification of skin changes that may indicate the onset of SJS. This aspect of Lamotrigine's safety profile underscores the necessity for healthcare providers to educate patients about recognizing early symptoms of skin reactions.

Other options listed, such as erythema multiforme or psoriasis flare-ups, may also occur but are less commonly associated with Lamotrigine compared to SJS. Itchy rashes can occur with numerous medications, but they typically do not carry the same level of risk as SJS in the context of Lamotrigine use.