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Cited by 31Pharmacovigilance and Adverse Drug ReactionsDrug-Induced Adverse ReactionsEpilepsy research and treatment

Lamotrigine and aseptic meningitis

Simms, Kelley M., Kortepeter, Cindy, Avigan, Mark·2012·Neurology
DOI 10.1212/wnl.0b013e31824c4634
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Abstract

Objective: The purpose of this case series is to characterize a recently identified association of the antiepileptic drug (AED) lamotrigine with aseptic meningitis based on cases reported to the Food and Drug Administration (FDA)'s Adverse Event Reporting System (AERS) database. Methods: We performed a data mining analysis of 9 AEDs from the FDA's AERS database. We applied the multi-item gamma Poisson shrinker (MGPS) algorithm to the entire AERS database through November 2, 2009, to generate empirical Bayes geometric mean (EBGM) values with corresponding confidence intervals for 9 AEDs and the adverse event code “meningitis aseptic.” The AERS database was also searched for postmarketing reports of aseptic meningitis associated with lamotrigine and a detailed review of each case was performed. Results: Forty AERS cases were identified in this review. Findings from the AERS reports revealed CSF profiles with features of both bacterial as well as viral meningitis. Fifteen cases documented a positive rechallenge; the median time to onset of symptoms upon rechallenge was only 60 minutes. Data mining analysis of several anticonvulsants resulted in disproportionate reporting solely for lamotrigine. Conclusion: There appears to be an association between lamotrigine use and aseptic meningitis. It is notable that nearly 40% of cases in this case series reported a positive rechallenge. Lamotrigine-associated aseptic meningitis should be considered in the differential diagnosis of culture-negative meningitis. This case series highlights the need for continued pharmacovigilance and the importance of systematic monitoring of patients treated with antiepileptic medications. AED= : antiepileptic drug; AERS= : Adverse Event Reporting System; DRESS= : drug reaction with eosinophilia and systemic symptoms; EBGM= : empirical Bayes geometric mean; FDA= : Food and Drug Administration; MedDRA= : Medical Dictionary for Regulatory Activities; MGPS= : multi-item gamma Poisson shrinker; PMN= : polymorphonuclear leukocyte; PT= : preferred term; WBC= : white blood cell

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Crossref · 10.1212/wnl.0b013e31824c4634

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19 of 19 references verified0 citation errors · 0 not checkable

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  • Non-infectious mimics of ABM include subarachnoid haemorrhage, autoimmune syndromes, paraneoplastic syndromes, migraine and rarely medications such as lamotrigine and cotrimoxazole.

    “Non-infectious mimics of ABM include subarachnoid haemorrhage, autoimmune syndromes, paraneoplastic syndromes, migraine and rarely medications, such as lamotrigine and cotrimoxazole.35”

    From Community-acquired acute bacterial meningitis in adults: a clinical update (2019) · cites this paper as [35]

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Authors
Simms, K. M., Kortepeter, C., & Avigan, M.
Affiliations
United States Food and Drug Administration (US)
ORCID
Venue
Neurology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-03-20
Volume
78
Issue
12
Pages
921-927
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
DOI
10.1212/wnl.0b013e31824c4634
OpenAlex
W1997575018
Cited by
31
References
19
Citations by year
2026: 1 · 2025: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 6 · 2013: 2 · 2012: 4
FWCI
6.26
Type
journal article
Language
en
Open access
closed
Locations
  • Neurology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
  • Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
  • Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
Keywords
lamotrigine, aseptic meningitis, antiepileptic drugs, adverse drug reactions, drug rechallenge, culture-negative meningitis, pharmacovigilance, drug safety, adverse event reporting
MeSH terms
Lamotrigine, Adolescent, Adult, Aged, Algorithms, Animals, Anticonvulsants, Antidepressive Agents, Bipolar Disorder, Child, Child, Preschool, Emergency Medical Services, Epilepsy, Female, Fever, Headache, Humans, Infant, Meningitis, Aseptic, Middle Aged, Triazines, United States, United States Food and Drug Administration, Vomiting, Databases, Factual, Neck Pain, Young Adult, Data Mining, Pharmacovigilance

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