Anticonvulsant hypersensitivity syndrome associated with bellamine s, a therapy for menopausal symptoms

Anticonvulsant hypersensitivity syndrome (AHS) is a rare, potentially fatal, idiosyncratic drug reaction characterized by fever, morbilliform rash, lymphadenopathy, hepatitis, and hematologic abnormalities. Aromatic antiepileptic agents, such as phenytoin, carbamazepine, and phenobarbital are the mo...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2004-05, Vol.50 (5), p.86-89
Main Authors: Turner, Ryan B, Kim, Caroline Choi, Streams, Brian N, Culpepper, Keliegh, Haynes, Harley A
Format: Article
Language:English
Subjects:
Anticonvulsants - adverse effects
Anticonvulsants - therapeutic use
Belladonna Alkaloids - adverse effects
Belladonna Alkaloids - therapeutic use
Biological and medical sciences
Drug Combinations
Drug Hypersensitivity - etiology
Drug toxicity and drugs side effects treatment
Ergotamines - adverse effects
Ergotamines - therapeutic use
Female
Hot Flashes - drug therapy
Humans
Medical sciences
Menopause
Middle Aged
Pharmacology. Drug treatments
Phenobarbital - adverse effects
Phenobarbital - therapeutic use
Toxicity: nervous system and muscle
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Summary:Anticonvulsant hypersensitivity syndrome (AHS) is a rare, potentially fatal, idiosyncratic drug reaction characterized by fever, morbilliform rash, lymphadenopathy, hepatitis, and hematologic abnormalities. Aromatic antiepileptic agents, such as phenytoin, carbamazepine, and phenobarbital are the most frequent causes of this syndrome. We report a case of a previously healthy, postmenopausal woman who developed anticonvulsant hypersensitivity syndrome while taking Bellamine S (belladonna alkaloids; ergotamine; phenobarbital) for hot flashes. Although combinations of belladonna, ergotamine, and phenobarbital have been used for medical treatment of menopausal symptoms since the 1960s, this is the first known case report of its association with anticonvulsant hypersensitivity syndrome. Given the current debate about the risks of hormonal replacement therapy, more women are seeking alternative therapies for menopausal symptoms. Dermatologists need to be aware of this potential serious reaction to this phenobarbital-containing therapy for hot flashes.
ISSN:0190-9622
1097-6787
DOI:10.1016/S0190-9622(03)02800-7