Review of carbamazepine-induced hyponatremia

Gandelman, Mitchell S.

doi:10.1016/0278-5846(94)90055-8

Cited by 33 publications

(19 citation statements)

References 34 publications

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“…9 Several published studies suggested CBZ-induced hyponatremia is dose dependent. 7,8, 10 We have noted that an association between CBZ dose and hyponatremia, if present, is weak.…”

mentioning

confidence: 99%

Hyponatremia from oxcarbazepine and carbamazepine

Leppik²,

et al. 2005

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The authors examined sodium concentrations from 97 oxcarbazepine-treated (OXC) and 451 carbamazepine-treated (CBZ) patients with epilepsy using cross-section and follow-up studies. The frequency of hyponatremia (Na+ < or = 134 mEq/L) was 29.9% among OXC-treated patients and 13.5% among CBZ-treated patients (p < 0.0001). Hyponatremia (Na+ < or = 128 mEq/L) was severe: 12.4% of OXC-treated patients and 2.8% of CBZ-treated patients (p < 0.001). Advanced age was a risk factor for hyponatremia. Hyponatremia, once present, persisted in both groups.

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“…9 Several published studies suggested CBZ-induced hyponatremia is dose dependent. 7,8, 10 We have noted that an association between CBZ dose and hyponatremia, if present, is weak.…”

mentioning

confidence: 99%

Hyponatremia from oxcarbazepine and carbamazepine

Leppik²,

et al. 2005

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“…CBZ-induced hyponatremia is uncommon in patients treated with CBZ alone (Gandelman 1994). Although the predisposing risk factors include age, CBZ dosage/level, and polypharmacy, polypharmacy is a particularly important risk factor (Kuz and Manssourian 2005).…”

Section: Discussionmentioning

confidence: 99%

“…CBZ-induced hyponatremia is a well-described side effect, and numerous studies have shown that age, hyponatremia dosage/level, and polypharmacy are predisposing risk factors for CBZ-induced hyponatremia (Gandelman 1994). Polypharmacy is a particularly important risk factor (Kuz and Manssourian 2005).…”

Section: Introductionmentioning

confidence: 99%

Interferon-alpha is a predisposing risk factor for carbamazepine-induced hyponatremia: A case of syndrome of inappropriate antidiuresis caused by interferon-alpha therapy

Tanaka

Kamoi²,

Takahashi³

2008

IJGM

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Abstract:A 31-year-old man had been treated with carbamazepine (CBZ) for 6 years and warfarin with bucolome for 2 years before developing hyponatremia 7 days after an injection of interferon-alpha 2b and starting oral ribavirin for chronic hepatitis C virus infection. Despite the hyponatremia, urinary osmolality exceeded plasma osmolality, and urinary excretion volume decreased markedly after water loading. Restriction of water intake and administration of dimethylchlortetracycline improved the hyponatremia, and lithium therapy maintained the normonatremia for one year. The hyponatremia recovered 6 months after the interferonalpha 2b therapy was completely stopped. In the present case, the syndrome of inappropriate antidiuresis may have been caused by the effect of interferon-alpha 2b on the renal distal tubules that had been sensitized by CBZ. Patients on CBZ therapy should be carefully observed for the development of hyponatremia when they are started on interferon-alpha 2b injections.

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“…In the central nervous system (CNS), CBZ reduces neuronal hyperexcitability and elicits its action mainly by inhibition of neuronal Na + and, to a lesser extent, also other channels and transmitter systems [3,4]. One side effect of CBZ therapy, especially in elderly patients with co-medication, is hyponatraemia [5]. This electrolyte disturbance is rather frequent, even though in most cases asymptomatic.…”

Section: Introductionmentioning

confidence: 99%

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

Himmerkus

Sievers

2012

Nephrology Dialysis Transplantation

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Background. Carbamazepine (CBZ) is a drug widely used in the therapy of epilepsy and mood disorders. One frequently observed side effect is hyponatraemia. The role of vasopressin in hyponatraemic action of CBZ is discussed controversially. In this study, we tested the influence of CBZ on water and salt homoeostasis in rat under different hydration states and under vasopressin 2 receptor (V2R) antagonism by satavaptan to elucidate the renal and vasopressin independent action of CBZ. Methods. CBZ-treated rats were investigated on metabolic cages after (i) 6 day with ad libitum fluid intake, (ii) moderate water load and (iii) water restriction. The effect of satavaptan was tested in clearance experiments under continuous saline infusion in anaesthetized rats after CBZ pretreatment. Results. Compared to controls, CBZ induced a higher urinary flow rate which was most pronounced (20-fold) after water load and significantly elevated (2-fold) after 10-h water restriction. In addition, CBZ consistently increased renal sodium loss but failed to decrease plasma sodium concentration. In the presence of satavaptan, urinary flow and natriuresis were further increased by CBZ, while there was no differential effect on urea excretion and anion gap. Conclusions. At the investigated dose (50 mg/kg body weight), CBZ did not induce hyponatraemia or antidiuresis in the rat. However, depending on the hydration state, it induced an increased water and electrolyte loss. Its enhanced influence on urinary flow and natriuresis in the presence of satavaptan suggests additional renal targets for CBZ, independent of vasopressin signalling.

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Review of carbamazepine-induced hyponatremia

Cited by 33 publications

References 34 publications

Hyponatremia from oxcarbazepine and carbamazepine

Hyponatremia from oxcarbazepine and carbamazepine

Interferon-alpha is a predisposing risk factor for carbamazepine-induced hyponatremia: A case of syndrome of inappropriate antidiuresis caused by interferon-alpha therapy

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

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