Many seizure drugs have the ability to cause Stevens-Johnson syndrome. The best approach to prevent this syndrome is to

A. Initiate the desired dose without titration and monitor closely for adverse events: Rapid initiation at full dose increases immune-mediated hypersensitivity risk associated with anticonvulsants. Stevens-Johnson syndrome is linked to sudden high drug exposure rather than delayed recognition alone. Monitoring does not prevent the underlying immunologic trigger. B. Initiate a high dose to achieve a therapeutic level then titrate the dose down: High initial dosing markedly increases the risk of severe cutaneous adverse reactions by overwhelming metabolic and immune tolerance pathways. Antiepileptic drugs associated with SJS require cautious exposure escalation. This approach heightens, rather than reduces, risk. C. Initiate a low dose and gradually titrate the dose up to a therapeutic level: Slow dose titration allows the immune system and hepatic metabolism to adapt to the medication. Gradual escalation reduces the incidence of severe hypersensitivity reactions, including Stevens-Johnson syndrome. This strategy is standard for seizure medications with known dermatologic risks. D. Initiate the desired dose accompanied by steroids to diminish adverse events: Prophylactic steroid use does not prevent Stevens-Johnson syndrome and may mask early warning signs such as rash or fever. Steroids do not alter the underlying drug–immune interaction responsible for SJS development.