Avoid tricyclics when seizure drug intolerable

NEW YORK (Reuters Health) - Patients who are hypersensitive to anticonvulsant drugs can show similar adverse reactions to older types of antidepressant medications called tricyclic antidepressants, according to a report in the Annals of Allergy, Asthma & Immunology.

"Anticonvulsant hypersensitivity syndrome," as doctors call it, is a rare side effect of anti-seizure therapy resulting in fever, rash, hepatitis, and swollen lymph nodes, the authors explain. Other drugs have also been implicated in this syndrome.

In their report, Dr. Axel Trautmann and colleagues from University of Wuerzburg, Germany describe 36 patients with hypersensitivity reactions to the anti-seizure drugs carbamazepine and phenytoin.

Five patients with carbamazepine-induced anticonvulsant hypersensitivity developed similar harmful reactions after taking tricyclic antidepressants, the authors report.

Four experienced moderate hypersensitivity symptoms and one developed severe symptoms.

"We suggest that patients with a history of anticonvulsant hypersensitivity syndrome due to anticonvulsant agents should not receive tricyclic antidepressants," the authors conclude.

SOURCE: Annals of Allergy Asthma Immunology, November 2006.