Hyponatremia induced by antiepileptic drugs in patients with epilepsy

Expert Opin Drug Saf. 2017 Jan;16(1):77-87. doi: 10.1080/14740338.2017.1248399. Epub 2016 Oct 27.

Abstract

Hyponatremia induced by antiepileptic drugs (AEDs) has not received sufficient attention in patients with epilepsy. Areas covered: We reviewed articles between 1966 and 2015 about hyponatremia as an adverse effect of AEDs in patients with epilepsy. The incidence, clinical symptoms, onset times of AEDs-induced hyponatremia are discussed in detail, as are the risk factors associated with AEDs-induced hyponatremia and mechanisms underlying its development. We also briefly describe strategies for treating AED-induced hyponatremia. Expert opinion: Carbamazepine and oxcarbazepine are the most common AEDs which induce hyponatremia in patients with epilepsy. Recently, other AEDs, such as eslicarbazepine, sodium valproate, lamotrigine, levetiracetam and gabapentin have also been reported to cause hyponatremia. Understanding the risk associated with AED-induced hyponatremia and taking effective measures to combat serum sodium imbalance induced by AED therapy are necessary.

Keywords: AEDs; Epilepsy; SIADH; hyponatremia; sodium.

Publication types

  • Review

MeSH terms

  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use
  • Carbamazepine / adverse effects
  • Carbamazepine / analogs & derivatives
  • Carbamazepine / therapeutic use
  • Epilepsy / drug therapy*
  • Humans
  • Hyponatremia / chemically induced*
  • Hyponatremia / epidemiology
  • Hyponatremia / therapy
  • Incidence
  • Oxcarbazepine
  • Risk Factors

Substances

  • Anticonvulsants
  • Carbamazepine
  • Oxcarbazepine