Patients with Epilepsy Being Treated with Oxcarbazepine Should Have Their Serum Sodium Levels Carefully Monitored

Although patients with epilepsy who are treated with oxcarbazepine frequently develop hyponatremia, even patients with severe cases are often asymptomatic, highlighting the importance of early identification of this condition in order to begin appropriate therapy.

The authors of “Frequency of and Risk Factors for Oxcarbazepine-induced Severe and Symptomatic Hyponatremia,” published in Seizure: European Journal of Epilepsy, reviewed the medical records of patients with epilepsy who were treated with the anticonvulsant oxcarbazepine to identify potential risk factors for the development of severe and/or symptomatic hyponatremia.

For the study, the authors analyzed the serum sodium levels of 1,009 patients with epilepsy who were treated with oxcarbazepine in the hospital setting. They found that 11.1% of patients developed severe hyponatremia, and 6.8% developed symptomatic hyponatremia.

They found that older patient age, treatment with antiepileptic drug combination therapy, and concomitant use of diuretics were independent risk factors for the development of severe oxcarbazepine-induced hyponatremia.

Older age and diuretic use were also independent risk factors for the development of symptomatic oxcarbazepine-induced hyponatremia.

Based on these findings the authors concluded that serum sodium should be monitored regularly in patients with epilepsy who are treated with oxcarbazepine‑‑especially in older patients, patients who are being treated with antiepileptic drug polytherapy, and in patients who are also taking diuretics‑‑to “assist in the early recognition of hyponatremia and to increase the awareness of symptoms that might be attributable to this.”