Clinical features of oxcarbazepine-associated cutaneous reactions in patients with bipolar disorder: a retrospective case series

Oxcarbazepine (OXC) is a second-generation antiepileptic drug that has been used in selected clinical settings as an alternative or adjunctive treatment option for bipolar disorder (BD). However, reports describing OXC-associated cutaneous reactions in patients with BD remain limited, and such reactions may complicate treatment and clinical management. We conducted a retrospective descriptive case series of 12 patients with BD who developed OXC-associated cutaneous reactions. Demographic characteristics, medication details, features of cutaneous reactions, and treatment outcomes were collected and analyzed. Among the 12 patients, the onset of cutaneous reactions occurred mainly within the first 2 weeks of treatment. The most common presentations were generalized eruptions, followed by localized eruptions, and 1 patient was diagnosed with Stevens-Johnson syndrome (SJS). Three patients received concomitant lamotrigine, including the patient with SJS, and mixed drug attribution could not be excluded. Clinical improvement was observed after discontinuation of OXC and supportive management. This retrospective descriptive case series provides clinical information on the presentation and management of OXC-associated cutaneous reactions in patients with BD. Given the small sample size, retrospective design, and absence of a comparison group, the findings should be interpreted descriptively and should not be used to estimate incidence, establish causality, or identify independent risk factors. Larger prospective studies are needed to further characterize these reactions. Not applicable.