Hyponatremia-induced seizure during carbamazepine treatment

Holtschmidt-Täschner, Bettina; Soyka, Michael

doi:10.1080/15622970600960157

Cited by 18 publications

(11 citation statements)

References 14 publications

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“…[8] A previous study has also reported a case of a 52-year-old female patient who presented with grand mal epilepsy as a consequence of hyponatremia due to carbamazepine. [9] Other anticonvulsants causing hyponatremia are oxcarbamazepine and lamotrigine. All these drugs alter the vasopressin levels in the renal tubules.…”

Section: Discussionmentioning

confidence: 99%

Carbamazepine-induced hyponatremia – A wakeup call

Kaeley

Kabi

Bhatia

et al. 2019

J Family Med Prim Care

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Carbamazepine-induced hyponatremia is a rare condition. The patients may or may not be symptomatic. Epilepsy is considered a social taboo. Hence, patients do not reveal history of being on antiepileptic agents. Carbamazepine is a known antiepileptic and psychotropic agent. It is commonly used for the treatment of seizures and psychiatric disorders. We present a case of a 60-year-old female patient presenting in emergency department with history of carbamazepine-induced hyponatremia. It raises antidiuretic hormone (ADH) levels. This leads to increased sensitivity of renal tubules to ADH levels. She was diagnosed as a case of syndrome of inappropriate ADH and was treated accordingly. She was asymptomatic and was ambulatory. She recovered significantly. Hence, it is essential to monitor sodium levels in patients on carbamazepine therapy and also on drugs with similar mechanism of action.

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Section: Discussionmentioning

confidence: 99%

Carbamazepine-induced hyponatremia – A wakeup call

Kaeley

Kabi

Bhatia

et al. 2019

J Family Med Prim Care

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“…[3] Grand-mal seizure related to hyponatremia (Na 125 mEq/L) in a 54-year-old woman after six weeks of carbamazepine treatment has been reported. [4] Possible mechanisms for the antidiuretic effects of carbamazepine include alteration in sensitivity or set-point ofhypothalamic osmoreceptors or increased sensitivity of the renal tubules to circulating anti-diuretic hormone. [4] Carbamazepine can induce kidney water absorption by increasing aquaporin-2 expression in inner medullary collecting ducts.…”

Section: Discussionmentioning

confidence: 99%

Carbamazepine-induced hyponatremia

Prakash

Bhatia

Raheja

et al. 2016

British Journal of Anaesthesia

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“…An ADR is considered severe if, -it is (potentially) life-threatening or seriously endangers a patient's health, -it causes considerable impairment of everyday functioning, or -it makes a transfer to another ward or department necessary for more specialized care (Grohmann et al 2004(Grohmann et al , 2014.…”

Section: Methodsmentioning

confidence: 99%

“…The AMSP protocol provides additional guidelines based on each organ system to further standardize classification (Grohmann et al 2014).…”

Section: Methodsmentioning

confidence: 99%

Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update

Seifert

Letmaier

Greiner³

et al. 2021

J Neural Transm

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Hyponatremia (HN) is the most common electrolyte imbalance (defined as a serum sodium concentration Na(S) of < 130 mmol/l) and often induced by drugs including psychotropic drugs. AMSP (Arzneimittelsicherheit in der Psychiatrie) is a multicenter drug surveillance program that assesses severe or unusual adverse drug reactions (ADRs) occurring during treatment with psychotropic drugs. This study presents data from 462,661 psychiatric inpatients treated in participating hospitals between 1993 and 2016 and serves as an update of a previous contribution by Letmaier et al. (JAMA 15(6):739–748, 2012). A total of 210 cases of HN were observed affecting 0.05% of patients. 57.1% of cases presented symptomatically; 19.0% presented with severe symptoms (e.g., seizures, vomiting). HN occurred after a median of 7 days following the first dose or dose increase. Incidence of HN was highest among the two antiepileptic drugs oxcarbazepine (1.661% of patients treated) and carbamazepine (0.169%), followed by selective serotonin-norepinephrine reuptake inhibitors (SSNRIs, 0.088%) and selective serotonin reuptake inhibitors (0.071%). Antipsychotic drugs, tricyclic antidepressants, and mirtazapine exhibited a significantly lower incidence of HN. The risk of HN was 16–42 times higher among patients concomitantly treated with other potentially HN-inducing drugs such as diuretic drugs, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and proton pump inhibitors. Female SSNRI-users aged ≥ 65 years concomitantly using other HN-inducing drugs were the population subgroup with the highest risk of developing HN. The identification of high-risk drug combinations and vulnerable patient subgroups represents a significant step in the improvement of drug safety and facilitates the implementation of precautionary measures.

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Hyponatremia-induced seizure during carbamazepine treatment

Cited by 18 publications

References 14 publications

Carbamazepine-induced hyponatremia – A wakeup call

Carbamazepine-induced hyponatremia – A wakeup call

Carbamazepine-induced hyponatremia

Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update

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