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首页> 外文期刊>The journal of clinical psychiatry >Dermatology precautions and slower titration yield low incidence of lamotrigine treatment-emergent rash.
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Dermatology precautions and slower titration yield low incidence of lamotrigine treatment-emergent rash.

机译：皮肤病学预防措施和较慢的滴定速度可降低拉莫三嗪治疗出疹子的发生率。

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OBJECTIVE: To assess treatment-emergent rash incidence when using dermatology precautions (limited antigen exposure) and slower titration during lamotrigine initiation. METHOD: We assessed rash incidence in 100 patients with DSM-IV bipolar disorder instructed, for their first 3 months taking lamotrigine, to avoid other new medicines and new foods, cosmetics, conditioners, deodorants, detergents, and fabric softeners, as well as sunburn and exposure to poison ivy/oak. Lamotrigine was not started within 2 weeks of a rash, viral syndrome, or vaccination. In addition, lamotrigine was titrated more slowly than in the prescribing information. Patients were monitored for rash and clinical phenomena using the Systematic Treatment Enhancement Program for Bipolar Disorder Clinical Monitoring Form. Descriptive statistics were compiled. RESULTS: No patient had serious rash. Benign rash occurred in 5 patients (5%) and resolved uneventfully in 3 patients discontinuing and 2 patients continuing lamotrigine. Two patients with rash were found to be not adherent to dermatology precautions. Therefore, among the remaining patients, only 3/98 (3.1%) had benign rashes. CONCLUSION: The observed rate of benign rash was lower than the 10% incidence in other clinical studies. The design of this study confounds efforts to determine the relative contributions of slower titration versus dermatology precautions to the low rate of rash. Systematic studies are needed to confirm these preliminary findings, which suggest that adhering to dermatology precautions with slower titration may yield a low incidence of rash with lamotrigine.
机译：目的：评估使用皮肤病学预防措施（有限的抗原暴露）和拉莫三嗪启动过程中较慢的滴定时出现的治疗性皮疹发生率。方法：我们评估了100名患有DSM-IV双相情感障碍的患者的皮疹发生率，这些患者在接受拉莫三嗪治疗的头3个月内应避免使用其他新药和新食品，化妆品，护发素，除臭剂，洗涤剂和织物柔软剂以及晒伤并接触常春藤/橡树。在出现皮疹，病毒综合症或接种疫苗后的两周内未开始使用拉莫三嗪。此外，拉莫三嗪的滴定速度比处方信息中的滴定速度慢。使用“双相情感障碍临床监测系统治疗方案”对患者的皮疹和临床现象进行监测。描述性统计被汇编。结果：无患者出现严重皮疹。良性皮疹发生在5例患者中（5％），在3例停药患者和2例继续使用拉莫三嗪的患者中均未得到良好解决。发现两名皮疹患者不遵守皮肤病预防措施。因此，在其余患者中，只有3/98（3.1％）患有良性皮疹。结论：在其他临床研究中，观察到的良性皮疹发生率低于10％的发生率。本研究的设计混淆了确定滴定速度慢与皮肤病预防措施对低皮疹发生率的相对影响的努力。需要系统的研究来证实这些初步发现，这表明坚持皮肤病预防措施并进行较慢的滴定可能会导致拉莫三嗪皮疹的发生率较低。

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