Review of carbamazepine-induced hyponatremia

  title={Review of carbamazepine-induced hyponatremia},
  author={Mitchell S. Gandelman},
  journal={Progress in Neuro-Psychopharmacology and Biological Psychiatry},
  • M. Gandelman
  • Published 1 March 1994
  • Medicine, Psychology
  • Progress in Neuro-Psychopharmacology and Biological Psychiatry

Incidence and Predictive Factors of Hyponatremia in Acute Carbamazepine Exposure

Although hyponatremia is common in acute CBZ poisoning, it remains under diagnosed, especially when it is asymptomatic, so it is imperative to regular ionogram control and stop treatment when it occurs.

[Carbamazepine-induced hyponatremia].

The case of a 59-year-old man with arterial hypertension, already treated with hydrochlorothiazide, who presented with hyponatremia after starting administration of carbamazepine is described and routine assessment of blood electrolytes is reasonable.

Carbamazepine-induced hyponatremia – A wakeup call

A case of a 60-year-old female patient presenting in emergency department with history of carbamazepine-induced hyponatremia is presented, diagnosed as a case of syndrome of inappropriate ADH and was treated accordingly.

Hyponatraemia Associated with Psychotropic Medications

Psychotropic medication-induced hyponatraemia is an uncommon but important clinical problem with potential serious consequences if not recognised and treated early. Several risk factors have been

Carbamazepine adverse drug reactions

Several factors should be considered for a safer use of CBZ, such as monotherapy prescription when possible, an adequate dose titration, knowledge of previous ADRs in the patient, and routine monitoring ofCBZ plasma concentrations in symptomatic patients.

Carbamazepine-Induced Hyponatremia: Assessment of Risk Factors

A 44-year-old white woman developed acute hyponatremia and 2 subsequent tonic–clonic seizures after ingesting twice her evening dose of carbamazepine (usual evening dose 600 mg) resulting in seizures.

Epidemiology, pathophysiology and putative genetic basis of carbamazepine‐ and oxcarbazepine‐induced hyponatremia

The use of carbamazepine and oxcarbazepine as first‐line antiepileptic drugs in the treatment of focal epilepsy is limited by hyponatremia, a known adverse effect that can lead to symptoms ranging from unsteadiness and mild confusion to seizures and coma.

Carbamazepine- or Oxcarbazepine-Induced Hyponatraemia or Leucopenia, or Both, in Residents with a Developmental Disability.

A negative correlation between sodium and serum carbamazepine levels was found and a population at risk of hyponatraemic effect was defined.

Hyponatremia from oxcarbazepine and carbamazepine

Examination of sodium concentrations from patients with epilepsy using cross-section and follow-up studies found that advanced age was a risk factor for hyponatremia, once present, persisted in both groups.

Carbamazepine affects water and electrolyte homoeostasis in rat--similarities and differences to vasopressin antagonism.

  • N. HimmerkusB. SieversM. Bleich
  • Medicine, Biology
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2012
Its enhanced influence on urinary flow and natriuresis in the presence of satavaptan suggests additional renal targets for CBZ, independent of vasopressin signalling.



Carbamazepine Side Effects in Children and Adults

In a study of the incidence of side effects in 220 children below the age of 16 years who were receiving carbamazepine, drowsiness, loss of coordination, and vertigo were the most commonly observed side effects and were almost always transient and dose related.

Absence of carbamazepine-induced hyponatremia among patients also given lithium.

There was a significant difference in serum sodium level between patients receiving carbamazepine alone and those also receiving lithium, and the protection against hyponatremia provided by the carbamazEPine-lithium combination occurred despite lithium's tendency to increase polyuria.

The antidiuretic action of carbamazepine in man.

It is concluded that the antidiuretic effect of carbamazepine is not the result of releasing endogenous antidiuresis hormone or of prolonging its half-life.

Hyponatremia during carbamazepine therapy

  • M. B. Lahr
  • Medicine
    Clinical pharmacology and therapeutics
  • 1985
The risk of hyponatremia increased with age and carbamazepine serum level (subjects >30 years old had three‐and‐a‐half times the prevalence as those with lower levels).

Carbamazepine in nonresponsive psychosis.

It appears that carbamazepine is worthwhile in patients with some aggression and interpersonal difficulties who are refractory to neuroleptics alone and who exhibit instability and agitation.

Carbamazepine-induced syndrome of inappropriate antidiuretic hormone secretion. Reversal by concomitant phenytoin therapy.

It was determined that the antidiuretic effect of carbamazepine could be blocked by phenytoin and the actions of both drugs on renal water excretion, and the interactions of the drugs were observed to be dose-related.

Carbamazepine and Serum Sodium Levels

Serum sodium levels of 674 epileptic patients were tabulated and the hyponatremic group was significantly older compared with the other groups, and the combination of CBZ, valproic acid, especially in high dosages, and barbiturates seemed to lead to hyp onatremia.

Hyponatraemia and carbamazepine intoxication

Serum sodium was inversely correlated with carbamazepine blood levels and hyponatraemia occurred in older patients, which was considered not to be due to water intoxication.

Carbamazepine and hyponatremia in patients with affective disorder.

It is suggested that caution be used in prescribing carbamazepine to patients with low or borderline low sodium values, as three of these patients developed frank symptoms of hyponatremia within 1-3 months of the start of therapy.

Water intoxication due to carbamazepine.

Two patients, one with trigeminal neuralgia, the other with epilepsy, who developed carbamazepine-induced abnormal water retention are described, which might provide a link between these two conditions.