title: Anticonvulsant hypersensitivity syndrome associated with Bellamine S, a therapy for menopausal symptoms.
abstract: 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.
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, USA.
authors.forename: Ryan B
authors.initials: RB
authors.lastname: Turner
authors.forename: Caroline Choi
authors.initials: CC
authors.lastname: Kim
authors.forename: Brian N
authors.initials: BN
authors.lastname: Streams
authors.forename: Keliegh
authors.initials: K
authors.lastname: Culpepper
authors.forename: Harley A
authors.initials: HA
authors.lastname: Haynes
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001533:Belladonna Alkaloids / Q000009:adverse effects* / Q000627:therapeutic use; D004338:Drug Combinations; D004342:Drug Hypersensitivity / Q000209:etiology*; D004879:Ergotamines / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010634:Phenobarbital / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D001533:Belladonna Alkaloids; D004338:Drug Combinations; D004879:Ergotamines; C014350:bellodona alkaloid, ergotamine, phenolbarbital drug combination; D010634:Phenobarbital