Symptomatology of carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy.

Autor: Berghuis B; Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands., Hulst J; Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands., Sonsma A; Centre of Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., McCormack M; Centre of Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., de Haan GJ; Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands., Sander JW; Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands.; NIHR UCL Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG & Chalfont Centre for Epilepsy, Chalfont, UK., Lindhout D; Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands.; Department of Human Genetics, University Medical Center Utrecht, Utrecht, The Netherlands., Koeleman BPC; Centre of Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Epilepsia [Epilepsia] 2021 Mar; Vol. 62 (3), pp. 778-784. Date of Electronic Publication: 2021 Feb 12.
DOI: 10.1111/epi.16828
Abstrakt: Objective: To ascertain whether adverse effects experienced by people taking carbamazepine or oxcarbazepine could be attributed to carbamazepine- or oxcarbazepine-induced hyponatremia (COIH).
Methods: We performed an observational study, collecting data between 2017 and 2019 on serum sodium levels and adverse effects retrospectively in people with epilepsy while receiving treatment with either carbamazepine (CBZ) or oxcarbazepine (OXC). We defined hyponatremia as sodium level ≤134 mEq/L and severe hyponatremia as sodium level ≤128 mEq/L. Adverse effects experienced were compared between groups of individuals with and without hyponatremia.
Results: A total of 1370 people using CBZ or OXC were identified, of whom 410 had at least one episode of hyponatremia. We checked for symptoms related to the use of CBZ and OXC in 710 people (410 with and 300 without hyponatremia) and found relevant information in 688. Adverse effects occurred in 65% of people with hyponatremia compared to 21% with normal sodium levels (odds ratio [OR] 7.5, P ≤ .001) and in 83% of people with severe hyponatremia compared to 55% in those with mild hyponatremia (P ≤ .001). Significant predictors of adverse effects were the drug (OXC vs CBZ), and the number of concomitant anti-seizure medications. Dizziness (28% vs 6%), tiredness (22% vs 7%), instability (19% vs 3%), and diplopia (16% vs 4%) were reported more often in the hyponatremia group than in patients with normal levels.
Significance: People with COIH had a 7-fold increased risk of developing adverse effects during treatment. Clinicians should consider ascertainment of sodium levels in patients taking CBZ and OXC and act upon findings.
(© 2021 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
Databáze: MEDLINE
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