Water intoxication due to carbamazepine.

Stephens, W P; Espir, Michael; Tattersall, R. B.; Quinn, Niall; Gladwell, Stephen; Galbraith, A. W.; Reynolds, E. H.

doi:10.1136/bmj.1.6063.754

Cited by 50 publications

(17 citation statements)

References 4 publications

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“…All values were normal. cases published by Stephens et al (1977), a thiazide derivative was used. The patient of Cathelineau and Surbled (1976) had vomited and was treated subsequently with 3 L of intravenous fluid.…”

Section: Hyponatremia Avp and Cyclic Ampmentioning

confidence: 99%

Carbamazepine and Serum Sodium Levels

et al. 1984

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Serum sodium levels of 674 epileptic patients were tabulated according to the following categories: less than 135 mmol/L, hyponatremia (28 patients); 135-145 mmol/L, normonatremia (530 patients); greater than 145 mmol/L, hypernatremia (116 patients). One hundred one patients were treated with antiepileptics without carbamazepine (CBZ), 113 with CBZ monotherapy, and 460 with CBZ plus other antiepileptic drugs. Twenty-three patients could be followed up after the first detection of a serum sodium level of less than 135 mg/L. Ten patients were consistently hyponatremic (greater than 50% of the follow-up measurements were less than 135 mg/L), whereas the remaining 13 were occasionally hyponatremic. The following facts could be derived from the study: (1) The hyponatremic group was significantly older compared with the other groups. (2) In patients not treated with CBZ, no hyponatremia was seen. Only two patients on CBZ monotherapy showed hyponatremia. (3) The combination of CBZ, valproic acid, especially in high dosages, and barbiturates seemed to lead to hyponatremia. (4) The excretion of antidiuretic hormone, measured in 12 patients, was subnormal (less than 25 ng/24 h) in seven hyponatremic patients and in three normonatremic patients and normal (25-250 ng/24 h) in two other normonatremic patients. (5) Cyclic AMP, measured in five hyponatremic patients, was normal. (6) In all patients the hyponatremia was slight and did not cause any clinical symptoms. Special treatment was not required.

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Section: Hyponatremia Avp and Cyclic Ampmentioning

confidence: 99%

Carbamazepine and Serum Sodium Levels

et al. 1984

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“…2 Although hyponatraemia is a well-recognized side-effect of carbamazepine therapy, it has previously been reported only at moderate or high doses and usually after weeks or months of treatment. [3][4][5][6][7][8][9] This paper reports a case of carbamazepine-induced hyponatraemia in a young Nigerian woman being treated for generalized tonicclonic seizures.…”

Section: Introductionmentioning

confidence: 99%

Hyponatraemia during low-dose carbamazepine therapy

Salawu

Danburam

2007

Ann Afr Med

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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.

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“…While carbamazepine has been shown to have an antidiuretic effect [1,4,6,7,9,11,12], phenytoin can reverse carbamazepine-induced water intoxication [10] and interferes (when given in high intravenous doses) with the release of [2]. It has been suggested that carbamazepine exerts its antidiuretic effect by stimulating the release of antidiuretic hormone from the posterior pituitary [1,4,9], but this could not be confirmed by others [3,11].…”

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confidence: 79%

Plasma arginine vasopressin concentrations in epileptics under monotherapy

1983

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Summary. Plasma arginine vasopressin concentrations were determined by radio-immunoassay in 112 adult epileptics who were taking carbamazepine, phenytoin, primidone, or sodium valproate in long-term monotherapy, and in 19 controls. No significant difference was found between the groups, but some epileptics taking carbamazepine and primidone showed low values. Serum concentrations of carbamazepine did not correlate with the concentrations of plasma arginine vasopressin. In conclusion, there was no evidence of a stimulating effect of chronic carbamazepine medication or a special inhibiting effect of phenytoin on the release of vasopressin arginine from the posterior pituitary.

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Water intoxication due to carbamazepine.

Cited by 50 publications

References 4 publications

Carbamazepine and Serum Sodium Levels

Carbamazepine and Serum Sodium Levels

Hyponatraemia during low-dose carbamazepine therapy

Plasma arginine vasopressin concentrations in epileptics under monotherapy

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