Hyponatraemia during low-dose carbamazepine therapy

Abstract

We report the syndrome of inappropriate antidiuresis as a much earlier side-effect of carbamazepine administration in a 29-year Nigerian female patient with generalized tonic-clonic seizures. Although asymptomatic, the biochemical abnormality improved after discontinuation of carbamazepine. Hyponatraemia developed after rechallenge with controlled release carbamazepine. The authors suggest that serum sodium levels be carried out before commencement of carbamazepine and caution be used in prescribing carbamazepine to patients with low or borderline low sodium values. Key words: Carbamazepine, hyponatraemia RésuméNous rapportons le syndrome de l'antidicirose inappropriée comme beaucoup plus tôt aux effets secondaires de l'administration carbamazepine chez une malade nigériane âgée de 29 ans avec de la convulsion toniques clonique généralisée. Bien que asymptomatique, l'anomalie biochimique avait amélioré après l'arrêt de la carbamazepine. L'hyponatemie avait développé après ré administration de la carbamazepine contrôlée. Les auteurs suggèrent que les niveaux de sérum de sodium devront être effectués avant le début de la carbamazephine et de prudence être utilisée dans l'ordonnance de la carbamazepine pour des patients atteints de la faible ou basse limite des valeurs de sodium.

Effects of Administration of Carbamazepine and/or Phenytoin on Serum Biochemical Parameters in Wistar Rats.

“…The result of the present study also disagrees with that of [23], who obtained hyponatraemia following CBZ administration. According to [13], PHE exerts a transient inhibitory effect on ADH release by the posterior pituitary gland, and it increases water reabsorption in the collecting duct of the kidneys, PHE has also been shown to reverse the hyponatraemia induced by CBZ therapy.…”

“…Its main function is reduction of sustained repetitive firing in neurones by blocking voltage-gated sodium channels [14]. CBZ exerts its therapeutic effects through the inhibition of brain neuronal activities, used for the treatment of seizure disorders and trigeminal and other neuralgias [23]. Severe liver failure is much less common in individuals using the drug, but has been reported with CBZ therapy [27], implicated in the aetiology of immunological abnormalities with decreased IgG, IgA and IgM [9].…”

A Case of Oxcarbazepine-Induced Severe Hyponatremia

“…Dolayısıy-la OKBZ kullanımına bağlı uygunsuz ADH sendromu gelişi-mi, hiponatremi oluşumundan sorumlu tutulmaktadır. [18,19] OKBZ kullanımına bağlı ortaya çıkan hiponatremi çoğun-lukla asemptomatik seyreder. Ancak gözden kaçırıldığı veya uygun tedavi edikmediği durumlarda bulantı, kusma, bilinç değişikliği, nöbet, ensefalopati, görme bozuklukları ve hatta ölüm gibi ciddi komplikasyonlara neden olabilir.…”