Bianca Berghuis1, Job van der Palen2,3, Gerrit-Jan de Haan1, Dick Lindhout1,4, Bobby P C Koeleman4, Josemir W Sander1,5,6. 1. Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands. 2. Department of Epidemiology, Medical School Twente, Enschede, The Netherlands. 3. Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, The Netherlands. 4. Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands. 5. NIHR UCL Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, United Kingdom. 6. Chalfont Centre for Epilepsy, Chalfont St. Peter, United Kingdom.
Abstract
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. Wiley Periodicals, Inc.
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. Wiley Periodicals, Inc.
Authors: Mendel Castle-Kirszbaum; Mervyn Kyi; Christopher Wright; Tony Goldschlager; R Andrew Danks; W Geoffrey Parkin Journal: Neurosurg Rev Date: 2021-01-03 Impact factor: 3.042
Authors: Bianca Berghuis; Caragh Stapleton; Anja C M Sonsma; Janic Hulst; Gerrit-Jan de Haan; Dick Lindhout; Rita Demurtas; Roland Krause; Chantal Depondt; Wolfram S Kunz; Federico Zara; Pasquale Striano; John Craig; Pauls Auce; Anthony G Marson; Hreinn Stefansson; Terence J O'Brien; Michael R Johnson; Graeme J Sills; Stefan Wolking; Holger Lerche; Sanjay M Sisodiya; Josemir W Sander; Gianpiero L Cavalleri; Bobby P C Koeleman; Mark McCormack Journal: Epilepsia Open Date: 2019-01-17
Authors: Robert T Wechsler; Rodney A Radtke; Michael Smith; David G Vossler; Laura Strom; Eugen Trinka; Hailong Cheng; Todd Grinnell; David Blum; Mariana Vieira; Joana Moreira; Francisco Rocha Journal: Epilepsia Date: 2019-07-01 Impact factor: 5.864
Authors: Henrik Falhammar; Jakob Skov; Jan Calissendorff; Jonatan D Lindh; Buster Mannheimer Journal: J Psychopharmacol Date: 2020-07-20 Impact factor: 4.153
Authors: Bianca Berghuis; Janic Hulst; Anja Sonsma; Mark McCormack; Gerrit-Jan de Haan; Josemir W Sander; Dick Lindhout; Bobby P C Koeleman Journal: Epilepsia Date: 2021-02-12 Impact factor: 5.864