Does valproic acid cause hyponatremia

Hyponatremia is a very commonly encountered clinical entity with potentially dangerous effects and for which many precipitating factors have been identified. We present a case of valproic acid (VPA) overdose causing profound hyponatremia, with one of the lowest serum sodium levels ever documented in literature.

Does sodium valproate cause hyponatremia?

We conclude that sodium valproate can cause an SIADH-like syndrome with hyponatremia and that serum sodium levels have to be monitored during treatment with high dosages of this drug.

What are the complications of valproic acid?

• drowsiness.
• dizziness.
• headache.
• diarrhea.
• constipation.
• changes in appetite.
• weight changes.
• back pain.

Does valproic acid cause hypernatremia?

The hypernatremia is due to VPA’s composition: sodium valproate (approximately 13.8 mg sodium/100 mg valproate) [5]. The hyperosmolality and anion gap acidosis result from elevated VPA metabolites which are organic anionic acids (propionic acid derivatives).

Which anticonvulsant causes 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.

Does lithium cause hyponatremia?

Chronic lithium intoxication is a life threatening, severe situation. Hyponatremia is a facilitating factor of lithium intoxication. Serum sodium levels should be regularly checked with serum lithium.

Can valproic acid cause low platelets?

Treatment with valproic acid (VPA), despite its efficacy in bipolar disorder and epilepsy, may be associated with thrombocytopenia. The risk factors for VPA-associated thrombocytopenia include female gender, advanced age, and high doses.

Does Depakote cause low sodium levels?

Administration of high doses of the mood stabilizer and antiepileptic drug sodium valproate can cause an SIADH-like syndrome with hyponatremia. We recommend that sodium levels be monitored regularly during administration of high doses of sodium valproate.

What causes hyponatremia?

Hyponatremia is decrease in serum sodium concentration < 136 mEq/L (< 136 mmol/L) caused by an excess of water relative to solute. Common causes include diuretic use, diarrhea, heart failure, liver disease, renal disease, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

What causes high valproic acid?

background information. Large overdose can cause delayed absorption of valproic acid from the gut, with levels peaking in a delayed fashion (up to 24 hours after the ingestion). This phenomenon is particularly notable for patients taking extended-release formulations.

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What is the most common side effect of the valproate family of drugs?

The most commonly reported side effects at the start of therapy include nausea, vomiting, and indigestion; these effects are usually transient.

What are the long term side effects of valproic acid?

• weakness, sluggishness, swelling of the face, loss of appetite, vomiting, or yellowish eyes or skin, especially in a child under 2 years of age (possible liver failure)
• pain in the abdomen, upset stomach, vomiting, or loss of appetite (possible disease of the pancreas)

Does valproic acid cause UTIS?

Conclusion: The study found that PHT, primidone, CBZ, and VPA in particular are associated with an increased risk of infections of the urinary tract. Oxcarbazepine, topiramate, and gabapentin are also associated with increased risk of UTI, albeit to a less significant extent.

Can lacosamide cause hyponatremia?

Lacosamide attains steady state concentration after 3 days on twice daily dosing regimen, 5 which also corelates with the onset of hyponatremia in our case. As per the Naranjo algorithm, the event scored a 7, which implies that lacosamide was the probable cause of hypoosmolar euvolemic hyponatremia.

Does tramadol cause hyponatremia?

Tramadol is a centrally acting synthetic opioid analgesic. This drug has been implicated as a cause of hyponatremia in exceptional cases.

How do you raise your sodium level?

Intravenous (IV) fluids with a high-concentration of sodium, and/or diuretics to raise your blood sodium levels. Loop Diuretics – also known as “water pills” as they work to raise blood sodium levels, by making you urinate out extra fluid.

What medications cause platelets to be low?

• Furosemide.
• Gold, used to treat arthritis.
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Penicillin.
• Quinidine.
• Quinine.
• Ranitidine.
• Sulfonamides.

Does sodium valproate cause low platelets?

The administration of sodium valproate to 30 patients in daily doses of 1,200 to 3,000 mg was associated with a significant reduction of the platelet count. Thrombocytopenia without any concomitant bleeding abnormalities occurred in 10 of the patients.

What is the most common cause of low platelet count?

One of the most common causes of low platelets is a condition called immune thrombocytopenia (ITP). You may hear it called by its old name, idiopathic thrombocytopenic purpura.

Does lithium cause hypernatremia or hyponatremia?

Of all psychotropic medicines, lithium is most likely to lead to polyuria and NDI, main risk factors for hypernatraemia. One study in 55 elderly patients found a lithium-associated hypernatraemia of ⩾150 mmol/L in 11%.

Does lithium help hyponatremia?

Lithium carbonate, useful in the treatment of manic-depressive disorders, can produce nephrogenic diabetes insipidus. The drug, therefore, has been used to facilitate renal waster excretion when severe hyponatremia occurs in the syndrome of inappropriate antidiuretic hormone secretion.

Does lithium affect sodium levels?

While taking lithium, do not make sudden changes to your salt intake. A sudden decrease in sodium intake (a component of salt) may result in higher serum lithium levels, while a sudden increase in sodium might prompt your lithium levels to fall.

What is the most common cause of hypernatremia?

Two common causes of hypernatremia are insufficient fluid intake and too much water loss. In rare cases, consuming too much sodium can cause hypernatremia to occur. The opposite of hypernatremia is hyponatremia. This condition occurs when a person’s serum sodium level is less than 135 mEq/l.

What causes Dilutional hyponatremia?

Water intoxication, also known as dilutional hyponatremia, develops only because the intake of water exceeds the kidney’s ability to eliminate water. Causes of this water intoxication include psychiatric disorder, forced water intake as a form of child abuse and iatrogenic infusion of excessive hypotonic fluid.

Who is most likely to get hyponatremia?

Hyponatremia is more likely in people living with certain diseases, like kidney failure, congestive heart failure, and diseases affecting the lungs, liver or brain. It often occurs with pain after surgery. Also, people taking medications like diuretics and some antidepressants are more at risk for this condition.

Does Topamax cause hyponatremia?

Recently, other AEDs, such as eslicarbazepine, sodium valproate, lamotrigine, le- vetiracetam, gabapentin, phenytoin, and topiramate have also been reported to be as- sociated with hyponatremia [16, 17] , though not with the same frequency as OXC and CBZ.

Does carbamazepine cause hyponatremia?

One cause of hyponatremia, the syndrome of inappropriate antidiuretic hormone (SIADH) secretion, has been associated with some drugs, including carbamazepine (CBZ). Because of its antidiuretic effects, CBZ has been used successfully to treat diabetes insipidus centralis.

Can phenytoin cause hyponatremia?

Phenytoin has been shown to inhibit the release of antidiuretic hormones [19] and has been thought not to induce hyponatremia. However, we found an increased risk of hyponatremia in patients using phenytoin (adjusted OR 1.68) but when analyzing newly initiated vs.

What is the difference between Depakote and valproic acid?

Divalproex sodium (Depakote), sodium valproate, and valproic acid are often confused. Valproic acid is the protonated form — in case that term doesn’t bring back memories from biochemistry, that means that the compound is bonded to a proton (H+). Sodium valproate, on the other hand, is the sodium salt of valproic acid.

What are the main side effects of sodium valproate?

• stomach pain, feeling or being sick.
• diarrhoea.
• dry or sore mouth, or swollen gums.
• shakes (tremors) in a part of your body, or unusual eye movements.
• feeling tired or sleepy.
• headache.
• weight gain.
• thinning hair, or changes to the colour or texture of your hair.

What does valproic acid treat?

Valproic acid is used to treat certain types of seizures (epilepsy). This medicine is an anticonvulsant that works in the brain tissue to stop seizures.