Tolvaptan: a new tool for the effective treatment of hyponatremia in psychotic disorders

Josiassen, Richard C.; Curtis, Jessica; Filmyer, Dawn M.; Audino, Brett; Skuban, Nina; Shaughnessy, Rita A.

doi:10.1517/14656561003610656

Cited by 15 publications

(11 citation statements)

References 59 publications

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“…These drugs can be administered intravenously (conivaptan, for up to 4 hospital days) or orally (tolvaptan, treatment must be initiated in the hospital) in euvolemic or hypervolemic hyponatremia of mild to moderate severity but not in hypovolemic hyponatremia. 9,[39][40][41][42][43] Because the aquaretic response to these drugs is variable, close vigilance of the trend of serum sodium is required. The introduction of vaptans generated great expectations, yet concerns about safety and cost currently limit the utility of these promising drugs for long-term management of hyponatremia.…”

Section: Repairing the Abnormal State Of The Determinants Of Hyponatrmentioning

confidence: 99%

The Challenge of Hyponatremia

Adrogué

Madias

2012

Journal of the American Society of Nephrology

136

172

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Treatment of hypotonic hyponatremia often challenges clinicians on many counts. Despite similar serum sodium concentrations, clinical manifestations can range from mild to life threatening. Some patients require active management, whereas others recover without intervention. Therapeutic measures frequently yield safe correction, yet the same measures can result in osmotic demyelination. To address this challenge, we present a practical approach to managing hyponatremia that centers on two elements: a diagnostic evaluation directed at the pathogenesis and putative causes of hyponatremia, the case-specific clinical and laboratory features, and the associated clinical risk; and a management plan tailored to the diagnostic findings that incorporates quantitative projections of fluid therapy and fluid losses on the patient's serum sodium, balances potential benefits and risks, and emphasizes vigilant monitoring. These principles should enable the clinician to formulate a management plan that addresses expeditiously three critical questions: Which of the determinants of the serum sodium are deranged and what is the underlying culprit? How urgent is the need for intervention? What specific therapy should be instituted and which are the associated pitfalls?

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Section: Repairing the Abnormal State Of The Determinants Of Hyponatrmentioning

confidence: 99%

The Challenge of Hyponatremia

Adrogué

Madias

2012

Journal of the American Society of Nephrology

136

172

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“…• Recently introduced drugs such as tolvaptan, a so-called vaptan (non-peptide arginine-vasopression antagonist -also known as aquaretics because they induce a highly hypotonic diuresis), and show promise in the treatment of hyponatremia of varying etiology, including that caused by drug-related SIADH [6,14,15].…”

Section: Antipsychotic Induced Hyponatremiamentioning

confidence: 99%

Psychiatric Aspects of Hyponatremia – A Clinical Approach

Sivaraman¹,

Rajajeyakumar²

2016

J Psychol Psychother

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“…Unlike traditional diuretics, Tolvaptan is a receptor antagonist of highly selective vasopressin V2 that promotes excretion of water without electrolyte. Besides, it neither in uences in vivo electrolyte content except for serum sodium ion, nor easily results in kidney failure [7]. Tolvaptan has been approved by many countries around the world for the treatment of autosomal dominant polycystic kidney disease, cardiac failure and hyponatremia [8][9].…”

Section: Introductionmentioning

confidence: 99%

Curative Effect and Safety of Tolvaptan Combined with Traditional Diuretics in Treatment of Patients with Cirrhotic Ascites and Relevant Research on its Dose: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

Liu

Zhang

et al. 2020

Preprint

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Background: Tolvaptan is a receptor antagonist of highly selective vasopressin V2, and it can promote excretion of water without electrolyte. Aims: To evaluated curative effect and safety of Tolvaptan in treatment of cirrhotic ascites, and its relationship with drug dose. Methods: Computer retrieval of PubMed, EMbase and The Cochrane Library was carried out to search the clinical trials of cirrhotic ascites treatment by Tolvaptan. The time limit of retrieval is from the database setup to May 31, 2019. 2 researchers independently screened studies, extracted the data and crosschecked. RevMan 5.3 software was used for Meta-analysis.Results: Finally, 6 articles and 848 patients were included in the study. Meta-analysis indicates that after the intervention for 7 days, serum sodium ion concentration of the combined diuretic group obviously increased, compared with the traditional diuretic group (WMD=2.92mmol/L, 95%CI [2.15, 3.70], P<0.001). In addition, Tolvaptan also can decrease patients’ ascites amount through increasing liquid discharge. However, the drug dose has no obvious correlation with the reduction degree of ascites amount. The rise of blood uric acid is the major adverse event in the treatment of cirrhotic ascites patients by Tolvaptan (OR=6.01, 95%CI [1.11, 32.56], P=0.04). When the dose of Tolvaptan rose to 15mg or 30mg, the total incidence of adverse events was obviously higher than it of traditional diuretic group.Conclusion: Tolvaptan combined with traditional diuretics has good curative effect for the patients with cirrhotic ascites. As its adverse reactions, the recommended dose of Tolvaptan is 7.5mg in the combined therapy.

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Tolvaptan: a new tool for the effective treatment of hyponatremia in psychotic disorders

Cited by 15 publications

References 59 publications

The Challenge of Hyponatremia

The Challenge of Hyponatremia

Psychiatric Aspects of Hyponatremia – A Clinical Approach

Curative Effect and Safety of Tolvaptan Combined with Traditional Diuretics in Treatment of Patients with Cirrhotic Ascites and Relevant Research on its Dose: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

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