title: Frequency of and risk factors for oxcarbazepine-induced severe and symptomatic hyponatremia.
abstract: OBJECTIVE
  Hyponatremia is one of the most common adverse effects in patients treated with oxcarbazepine (OXC). Most patients with OXC-induced hyponatremia are asymptomatic, so the presence of severe or symptomatic hyponatremia, which requires electrolyte correction or discontinuation of OXC therapy, has more important clinically implications. However, data for OXC-induced severe and symptomatic hyponatremia are limited.
  
  
  METHODS
  We reviewed medical records of all patients with epilepsy who were treated with OXC at the Seoul National University Hospital. We analyzed serum sodium level results and attempted to identify correlations between various factors and the frequency of severe and symptomatic OXC-induced hyponatremia.
  
  
  RESULTS
  Data from a total 1009 patient were examined. The frequency of severe and symptomatic hyponatremia was 11.1% and 6.8%, respectively. Multivariate analysis revealed that age (P=0.014, OR 1.014), antiepileptic drug (AED) polytherapy (P=0.040, OR 1.540), and the concomitant use of diuretics (P<0.001, OR 5.597) were independent risk factors for OXC-induced severe hyponatremia. Age (P=0.001, OR 1.034) and the concomitant use of diuretics (P=0.035, OR 2.222) were independent risk factors for OXC-induced symptomatic hyponatremia. The frequency of OXC-induced symptomatic hyponatremia that was judged to be clinically significant was 2.8% among the total OXC-treated epilepsy patients.
  
  
  CONCLUSIONS
  Our study recommended that serum sodium be monitored regularly in patients taking OXC, especially in old age, AED polytherapy or concomitant use of diuretics, to assist in the early recognition of hyponatremia and to increase the awareness of symptoms that might be attributable to this.
authors.affiliation: Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea.
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Kon-kuk University School of Medicine, Seoul, South Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Keun-Hwa
authors.initials: KH
authors.lastname: Jung
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Soon-Tae
authors.initials: ST
authors.lastname: Lee
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Bong Su
authors.initials: BS
authors.lastname: Kang
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Jung-Ick
authors.initials: JI
authors.lastname: Byun
authors.affiliation: Department of Pediatrics, Gyeong-sang National University School of Medicine, Jin-ju, South Korea.
authors.forename: Jung Sook
authors.initials: JS
authors.lastname: Yeom
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Kon
authors.initials: K
authors.lastname: Chu
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: sangkun2923@gmail.com.
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000009:adverse effects*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000139:chemically induced*; D026121:Indole Alkaloids / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D026121:Indole Alkaloids; C512235:oxoassoanine; D012964:Sodium
keywords: Antiepileptic drug; Hyponatremia; Oxcarbazepine