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When do you recommend HLA testing prior to prescribing lamotrigine, carbamazepine, or oxcarbazepine to patients of Asian descent?

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How often do you perform HLA testing prior to prescribing lamotrigine, carbamazepine, or oxcarbazepine to patients of Asian descent?

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3 Answers
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Psychiatry · South Broward Hospital District
Answered on · Updated on

I never use carbamazepine, given how it’s a pan-inducer and often lowers the level of other medications that may be in the regimen, such as quetiapine and haloperidol, since they are mainly metabolized by CYP3A4.

Oxcarbazepine has a 50% reduction in the induction of carbamazepine, so I use that somet...

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Psychiatry · Siu Psychiatry
Answered on

This is one of the few actionable tests to avoid the more frequent occurrence of DRESS (Drug Rash with Eosinophilia Syndrome) or SJS (Stevens-Johnson Syndrome). Practically speaking, it is unusual for clinicians to have these HLA tests available in a fashion timely enough to match the usual need for...

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Mednet Member
Psychiatry · Salam Psychiatric Services, PLC.
Answered on

I’ve never had a patient who needed this.

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