Introduction 65 ( 12) 1976-1978 Get Access Abstract Publication History References Abstract The authors examined sodium concentrations from 97 oxcarbazepine-treated (OXC) and 451 carbamazepine-treated (CBZ) patients with epilepsy using cross-section and follow-up studies
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Certain drugs (eg, diuretics, antidepressants, and antiepileptics) have been implicated as established causes of either asymptomatic or symptomatic hyponatremia
Hyponatremia is a common problem in people taking CBZ or OXC
Oxcarbazepine is FDA-approved for partial seizures in adults with epilepsy or partial seizures in children with epilepsy ages 4 to 16
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[] OXC monotherapy is as effective as that with CBZ, lithium, or valproic acid in treating bipolar patients and has fewer side effects
Oxcarbazepine is 10,11-Dihydro-10-oxo-5 H-dibenz[b, f]azepine-5-carboxamide, and its structural formula is: Oxcarbazepine is a white to faintly orange crystalline powder
With the addition of the oxcarbazepine, a follow up BMP was ordered which contained a sodium level
The patient maintained a normal serum sodium level and has had appropriately concentrated urine for 5 years on Oxcarbazepine, MHD, and carbamazepine all share a principal mechanism of action, which is the blockade of voltage-gated sodium channels
A mechanism other than SIADH may be partially responsible since cases of hyponatremia without abnormal ADH levels have been observed in some of the patients
1 It would seem reasonable to assume, Possible mechanisms for the anti-diuretic effects of carbamazepine include alteration in sensitivity or set-point ofhypothalamic osmoreceptors or increased sensitivity of the renal tubules to circulating anti-diuretic hormone
Possible hyponatremia Oxcarbazepine and its active MHD metabolite are distributed into milk
Patients may experience dizziness, headache, ataxia, nausea, rash, double vision, and/or hyponatremia
Certainly the effect of both compounds on animal seizure models is similar, although not identical
Oxcarbazepine (OXC) is an antiepileptic drug widely used in the treatment of bipolar disorder (BD), specially when there are side effects with other mood stabilizers
Hyponatremia
Psychotropic medications are commonly implicated in the etiology of drug induced SIADH
investigated the mechanisms by which oxcarbazepine can lead to hyponatremia in epilepsy and healthy subjects (Sachdeo et al
This activity will highlight the mechanism of action, adverse event profile, and other key factors pertinent to members of the healthcare Hyponatremia , from inappropriate secretion of antidiuretic hormone (SIADH) or an SIADH-like mechanism, is a common adverse effect of oxcarbazepine therapy
Results
Hyponatremia or low blood sodium may happen more often in older adults taking oxcarbazepine
Expert opinion: Carbamazepine and oxcarbazepine are the most common AEDs which induce hyponatremia in patients with epilepsy
Like other antiepileptic substances, their mechanism of action is thought to be the inhibition of the voltage-gated sodium channel
23 Due to its mechanism of action, oxcarbazepine toxicity is associated with neurologic, cardiovascular, and anticholinergic symptoms
Hyponatremia was defined as <136 mmol/L
Mechanism of Action
Altered sensitivity to serum osmolality by the hypothalamic osmoreceptors appears likely, but an
Hyponatremia (defined as a serum sodium level < 134 mmol/L) is the most common electrolyte abnormality in hospitalized patients
The patients may or may not be symptomatic
To ascertain whether adverse effects experienced by people taking carbamazepine or oxcarbazepine could be attributed to carbamazepine‐ or
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)
Oxcarbazepine and carbamazepine cause hyponatremia by unknown mechanisms
The incidence, clinical symptoms, onset times of AE
The authors examined sodium concentrations from 97 oxcarbazepine-treated (OXC) and 451 carbamazepine-treated (CBZ) patients with epilepsy using cross-section and follow-up studies
oxcarbazepine is more likely to cause hyponatremia compared to carbamazepine
With regard to the mechanism of development of hyponatremia during therapy with CBZ, it has been reported that CBZ stimulates antidiuretic hormone Hyponatremia has also been reported to occur frequently with oxcarbazepine, which is another AED that possesses a dibenzazepine skeleton‐like CBZ
Neurology
Understanding the mechanisms by which oxcarbazepine can lead to a reduction of serum sodium levels could have therapeutic implications for the few patients in whom symptomatic hyponatremia develops
Although the precise mechanism of action is unknown, in vitro electrophysiological studies indicate that OXC and MHD possess multiple mechanisms of action that may prevent the spread of seizures in the healthy brain: Dong X, Leppik IE, White J, Rarick J (2005) Hyponatremia from oxcarbazepine and carbamazepine
The precise mechanism by which oxcarbazepine and MHD exert their anti-seizure effect is
Eslicarbazepine is increasingly used as an alternative to Clinically significant hyponatremia generally occurred during the first three months of treatment with oxcarbazepine, although there were patients who first developed a serum sodium <125 mmol/L more than one year after initiation of therapy
5-3% of psychiatric patients develop severe hyponatremia
Clinically significant hyponatremia (sodium <125 mmol/L) can develop during oxcarbazepine use
Carbamazepine is used to manage and treat epilepsy, trigeminal neuralgia, and acute manic and mixed episodes in bipolar I disorder
investigated the mechanisms by which oxcarbazepine can lead to hyponatremia in epilepsy and healthy subjects (Sachdeo et al