OBJECTIVE: To describe a case of a possible incipient Stevens-Johnson reaction while a patient had been on a stable dose of lamotrigine for several months and to consider the likely cause. METHODS: The history is recounted. RESULTS: One likely cause implicates differing effective doses of lamotrigine across differing brands and raises quality control issues. CONCLUSION: The patient's severe reaction may reflect changing to a brand of lamotrigine that precipitously generated a higher serum level of lamotrigine.
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