Anti-Seizure Drugs Linked to a Quarter of Stevens-Johnson Syndrome Cases

Researchers noted that children faced a higher risk of severe skin reactions to antiepilepsy medications than adults.

According to a new study, patients taking medications designed to treat epilepsy and other seizure disorders, including Lamictal, Dilantin and Tegretol, may face an increased risk of severe and potentially deadly skin reactions.

The findings were published in JAMA Dermatology late last month. In the study, Canadian researchers analyzed years of data linking use of the anti-seizure drugs to incidents of Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN), suggesting these medications may be leading causes of the conditions.

Stevens-Johnson Syndrome

SJS is a rare skin reaction usually triggered by a medication. Often beginning with flu-like symptoms, patients develop painful rashes. If diagnosis is delayed and SJS goes untreated, it can destroy skin, cause blindness and become life-threatening.

Once more than 30% of the skin is affected, an SJS diagnosis is upgraded to TEN, symptoms of which include widespread blistering and peeling skin and damage to the mucous membrane, typically resulting in the need for inpatient treatment in a hospital burn unit.

Side effects of both conditions can include vision impairment, permanent skin damage, sepsis, meningitis, organ failure, acute respiratory failure and in some cases death. Treatment requires immediately stopping the drug suspected of causing the condition, administering fluids, preventing infections and managing pain.

Over the past few decades, various drug manufacturers have faced SJS lawsuits and TENS lawsuits involving claims that specific products do not contain adequate warnings about the risk of users developing the dangerous skin reactions.

Anti-Seizure Medication Skin Disorders

For the new study, a team of researchers from the University Health Network and Sinai Health conducted a meta-analysis of 50 observational studies published before March 2026. Led by Dr. Ericka Yue Lee, they looked at data on confirmed cases of SJS and TEN, identifying 4,403 individuals.

The researchers examined incidents of antiepileptic drugs (AEDs) tied to SJS/TEN reactions, finding that antiepileptics accounted for nearly 23% of all SJS and TEN diagnoses, including approximately 88% of cases attributed to a single drug exposure. Virtually all of those cases were linked to a specific type of antiepileptic medications known as aromatic AEDs.

According to the data, 39% of those cases were linked to Tegretol use, 19% were linked to Dilantin, and 15% were associated with the use of Lamictal. They determined that nonaromatic AEDs accounted for less than 2% of all AED-linked SJS and TEN cases.

“SJS/TEN is considered the most serious type of drug hypersensitivity reaction, and in our analysis, at least 87% of cases reported worldwide were attributed to a single implicated drug.”

— Dr. Ericka Yue Lee, Proportion of Antiepileptic Drug–Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Additionally, the researchers noted that the risk was higher with pediatric use than when the drugs were used by adults. They also found that geography appeared to play a role, with higher rates of diagnoses in West Asia and the lowest rates detected in Africa.

The team concluded that aromatic AEDs are a leading cause of SJS and TEN, urging doctors to favor the use of nonaromatic antiseizure medications when clinically appropriate.

Sign up for more health and legal news that could affect you or your family.