Two major studies published in 2026 add important new evidence about the relationship between antiseizure medications and Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Together, the studies help quantify both how frequently antiseizure drugs appear among SJS/TEN cases and the short-term absolute risk observed after patients start specific antiseizure medications.
A Large Meta-Analysis Finds Antiseizure Drugs in Nearly One-Quarter of SJS/TEN Cases
A systematic review and meta-analysis published online in JAMA Dermatology on July 22, 2026 examined 50 studies involving 4,403 patients with SJS/TEN. The researchers reported that 23% of SJS/TEN cases in the included studies were attributed to antiepileptic drugs.
The concentration among aromatic antiseizure medications was particularly notable. According to the analysis, 96% of antiepileptic-drug-associated SJS/TEN cases involved aromatic agents. Carbamazepine accounted for 39% of those drug-associated cases, phenytoin for 19%, and lamotrigine for 15%.
These percentages describe the distribution of implicated drugs among SJS/TEN cases in the studies; they are not the same as the probability that an individual patient taking one of these medications will develop SJS or TEN. That distinction is important when interpreting the findings.
A Nationwide Study Provides Medication-Specific Absolute Risk Estimates
A separate 2026 study published in Neurology examined 1,388,397 initiations of 25 antiseizure medications in Denmark between 1995 and 2024. Researchers identified 83 SJS/TEN cases within 90 days after treatment initiation and reported that most occurred during the first weeks.
Lamotrigine had the highest observed 90-day absolute risk in the study at 29.31 SJS/TEN cases per 100,000 initiators. Carbamazepine followed at 16.66 per 100,000, phenobarbital at 15.84, oxcarbazepine at 11.25, and valproic acid at 7.31. By comparison, the researchers estimated the general-population 90-day background risk at 0.17 per 100,000 individuals.
The study also reported a one-year mortality of 17% among the identified SJS/TEN cases. As with any observational study, these results require appropriate interpretation. They provide population-level estimates and do not determine the cause of a reaction in an individual patient.
Why Timing After Starting a Medication Matters
When physicians and other specialists evaluate a suspected medication-induced SJS/TEN case, the timing of medication exposure is a central part of causality assessment. The Neurology study's finding that most cases occurred in the first weeks after initiation is consistent with the clinical importance of carefully reconstructing when each medication was started, stopped, increased, decreased, or restarted.
For a patient who has taken several medications, identifying the responsible drug may require review of pharmacy records, hospital records, medication administration records, prescribing records, and the chronology of the first symptoms. The presence of a known association does not by itself establish that a particular medication caused an individual patient's SJS/TEN.
Lamotrigine and Carbamazepine Remain Particularly Important
The two 2026 studies approach the issue differently, but both reinforce the importance of lamotrigine and carbamazepine in SJS/TEN evaluation. The JAMA Dermatology meta-analysis found carbamazepine, phenytoin, and lamotrigine to be the most common antiseizure drugs among the drug-associated cases it analyzed. The Danish cohort, which measured risk after starting individual medications, found the highest observed absolute risk with lamotrigine, followed by carbamazepine.
For patients and families, these findings do not mean that antiseizure medication should be stopped without medical direction. Abruptly stopping a medication used to control seizures can itself be dangerous. A suspected severe drug reaction requires urgent medical evaluation.
What the New Research Does — and Does Not — Establish
The new studies strengthen the contemporary medical literature concerning the association between particular antiseizure medications and SJS/TEN. They may also assist physicians, researchers, lawyers, and patients in understanding relative patterns of medication association and the importance of exposure timing.
They do not, standing alone, establish legal liability. Many antiseizure medications already carry serious skin-reaction warnings, and a viable legal claim depends on facts that can include the precise product involved, manufacturer, brand or generic status, warning language in effect at the relevant time, prescribing circumstances, medical and pharmacy records, causation evidence, jurisdiction, and applicable statutes of limitation.
Those distinctions can be especially important in SJS/TEN litigation because two patients with clinically similar injuries may have very different legal claims depending on which drug was taken, who manufactured it, what warnings applied at the time, and where the claim arose.
What Patients and Families Should Preserve
When SJS or TEN may have been caused by medication, preserving the medication history can be critical. Useful records can include prescription bottles or photographs of labels, pharmacy dispensing histories, medication lists, hospital and emergency-department records, dermatology or burn-center records, pathology reports, photographs of the reaction, and documentation showing when symptoms first appeared.
Because legal deadlines vary and can be affected by the jurisdiction and circumstances of the case, anyone investigating a potential claim should avoid assuming that a claim is timely—or untimely—without a case-specific analysis.
About Greg Jones Law and SJS/TEN
Greg Jones Law focuses substantial attention on medication-induced Stevens-Johnson syndrome and toxic epidermal necrolysis. The firm evaluates the causative medication, treatment history, severity of injury, potential responsible parties, and legal issues that can determine whether an SJS/TEN case has potential value.
Sources
Lee EY, Knox C, Sugumar C, Phillips EJ. “Proportion of Antiepileptic Drug-Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Meta-Analysis.” JAMA Dermatology. Published online July 22, 2026. DOI: 10.1001/jamadermatol.2026.2473. JAMA/PMC article
Heerfordt IM, et al. “Risk of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis After Initiation of Antiseizure Medication: A Danish Nationwide Cohort Study.” Neurology. 2026;107(3):e218355. DOI: 10.1212/WNL.0000000000218355. PubMed record