Henrik Falhammar1, Jonatan D Lindh2, Jan Calissendorff3, Jakob Skov4, David Nathanson5, Buster Mannheimer6. 1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden. Electronic address: henrik.falhammar@ki.se. 2. Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden. 3. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden. 4. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 5. Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. 6. Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Abstract
BACKGROUND: Antipsychotics have been claimed to cause hyponatremia. The risk associated with individual antipsychotics, or groups (first-generation [FGAs] or second-generation [SGAs] antipsychotics), is not well-documented. The objective of this study was to investigate the association between antipsychotics and hospitalization due to hyponatremia. METHODS: The general Swedish population was the base of this register-based case-control study. Comparisons were made between patients hospitalized with a principal diagnosis of hyponatremia (n = 14,359) and matched controls (n = 57,383). Multivariable logistic regression adjusting for concomitant drugs, medical conditions, previous hospitalizations and socioeconomic factors was performed to investigate the association between hyponatremia and antipsychotic use. In addition newly initiated (≤90 days) or ongoing use was analysed separately. RESULTS: Compared to controls, the adjusted OR (95%CI) for hospitalization due to hyponatremia was for any antipsychotic 1.67(1.5-1.86). Individuals on FGA were more likely to experience severe hyponatremia (2.12[1.83-2.46]) than those on any SGA (1.32[1.15-1.51]). No increased risks, neither as newly initiated nor ongoing therapy, were found for risperidone (0.86[0.56-1.31] and 0.83[0.67-1.02]) and aripiprazole (1.16[0.30-4.46] and 0.62[0.27-1.34]), respectively. CONCLUSIONS: There was an association between antipsychotic therapy and hospitalization due to hyponatremia. The association was stronger for FGAs than SGAs. Risperidone was not associated with an increased risk.
BACKGROUND: Antipsychotics have been claimed to cause hyponatremia. The risk associated with individual antipsychotics, or groups (first-generation [FGAs] or second-generation [SGAs] antipsychotics), is not well-documented. The objective of this study was to investigate the association between antipsychotics and hospitalization due to hyponatremia. METHODS: The general Swedish population was the base of this register-based case-control study. Comparisons were made between patients hospitalized with a principal diagnosis of hyponatremia (n = 14,359) and matched controls (n = 57,383). Multivariable logistic regression adjusting for concomitant drugs, medical conditions, previous hospitalizations and socioeconomic factors was performed to investigate the association between hyponatremia and antipsychotic use. In addition newly initiated (≤90 days) or ongoing use was analysed separately. RESULTS: Compared to controls, the adjusted OR (95%CI) for hospitalization due to hyponatremia was for any antipsychotic 1.67(1.5-1.86). Individuals on FGA were more likely to experience severe hyponatremia (2.12[1.83-2.46]) than those on any SGA (1.32[1.15-1.51]). No increased risks, neither as newly initiated nor ongoing therapy, were found for risperidone (0.86[0.56-1.31] and 0.83[0.67-1.02]) and aripiprazole (1.16[0.30-4.46] and 0.62[0.27-1.34]), respectively. CONCLUSIONS: There was an association between antipsychotic therapy and hospitalization due to hyponatremia. The association was stronger for FGAs than SGAs. Risperidone was not associated with an increased risk.
Authors: Henrik Falhammar; Jakob Skov; Jan Calissendorff; Jonatan D Lindh; Buster Mannheimer Journal: J Psychopharmacol Date: 2020-07-20 Impact factor: 4.153
Authors: Henrik Falhammar; Jakob Skov; Jan Calissendorff; David Nathanson; Jonatan D Lindh; Buster Mannheimer Journal: J Clin Endocrinol Metab Date: 2020-10-01 Impact factor: 5.958
Authors: Buster Mannheimer; Henrik Falhammar; Jan Calissendorff; Jakob Skov; Jonatan D Lindh Journal: J Psychopharmacol Date: 2021-04-16 Impact factor: 4.153
Authors: Johanna Seifert; Martin Letmaier; Timo Greiner; Michael Schneider; Maximilian Deest; Christian K Eberlein; Stefan Bleich; Renate Grohmann; Sermin Toto Journal: J Neural Transm (Vienna) Date: 2021-07-01 Impact factor: 3.575