Carbamazepine‐ and oxcarbazepine‐induced hyponatremia in people with epilepsy. (24th May 2017)

• Record Type: Journal Article
• Authors: Berghuis, Bianca; van der Palen, Job; de Haan, Gerrit‐Jan; Lindhout, Dick; Koeleman, Bobby P. C.; Sander, Josemir W.
• Other Names: Møller Rikke S. investigator.; Nikanorova Marina investigator.; Ingason Andrés investigator.; Depondt Chantal investigator.; Johnson Michael R investigator.; Langley Sarah R. investigator.; Klein Karl Martin investigator.; McCormack Mark investigator.; Delanty Norman investigator.; Cavalleri Gianpiero L. investigator.; van Zijl Janic investigator.; Muhle Hiltrud investigator.; Borghei Mojgansadat investigator.; Donatello Simona investigator.; Willis Joseph investigator.; Leu Costin investigator.; Heggeli Kristin investigator.; Avbersek Andreja investigator.; Sisodiya Sanjay M. investigator.; Gamberdella Antonio investigator.; Weckhuysen Sarah investigator.; Kunz Wolfram S. investigator.; Striano Pasquale investigator.; Zara Federico investigator.; Brodie Martin J. investigator.; Stefánsson Kári investigator.; Marson Anthony G investigator.; Jorgensen Andrea investigator.; Auce Pauls investigator.; Francis Ben investigator.; Srivastava Prashant investigator.; Sills Graeme J. investigator.; Primec Zvonka Rener investigator.; Krause Roland investigator.; Wolking Stefan investigator.; Weber Yvonne investigator.; Rau Sarah investigator.; Hengsbach Christian investigator.; Lerche Holger investigator.; Sonsma Anja investigator.; Krenn Martin investigator.; Zimprich Fritz investigator.; Pataraia Ekaterina investigator.;
• Is Part Of: Epilepsia. Volume 58:issue 7(2017)
• Page Start: 1227
• Page End: 1233
• Publication Date: 2017-05-24
• Subjects: Antiepileptic drugs -- Sodium levels -- Adverse effects -- Electrolytes; Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/epi.13777
• Languages: English
• ISSNs: 0013-9580

Abstract

Summary: Objective: To ascertain possible determinants of carbamazepine (CBZ)– and oxcarbazepine (OXC)–induced hyponatremia in a large cohort of people with epilepsy. Methods: We collected data on serum sodium levels in people with epilepsy who were attending a tertiary epilepsy center while on treatment with CBZ or OXC. We defined hyponatremia as Na+ ≤134 mEq/L and severe hyponatremia as Na+ ≤128 mEq/L. Results: We identified 1, 782 people who had used CBZ (n = 1, 424) or OXC (n = 358), of whom 50 were treated with both drugs. Data on sodium level measurements were available in 1, 132 on CBZ and in 289 on OXC. Hyponatremia occurred in 26% of those taking CBZ and 46% of those taking OXC. This was severe in 7% in the CBZ group and 22% in the OXC group. Hyponatremia was symptomatic in 48% and led to admissions in 3%. Age over 40 years, high serum levels of CBZ and OXC, and concomitant use of other antiepileptic drugs were the main risk factors for hyponatremia in both treatment groups. Female patients on OXC were at a higher risk than male patients of hyponatremia. The risk of hyponatremia on CBZ was significantly associated with the risk of hyponatremia on OXC within a subgroup that used both drugs consecutively. Significance: Hyponatremia is a common problem in people taking CBZ or OXC. Regular ascertainment of sodium levels in those taking either drug is recommended and results should be acted on.