European Journal of Biomedical and Pharmaceutical Sciences

CARBAMAZEPINE-INDUCED HYPONATREMIA

Dr. Arpitha Anil George*, Sushma D. R.

ABSTRACT

Carbamazepine is a widely used antiepileptic and mood-stabilizing medication, is known to cause clinically significant adverse effects such as hyponatremia, which may often go unnoticed in clinical practice. A 30-year-old male with a history of seizure disorder on maintenance therapy with Carbamazepine (1-0-2), chronic alcohol consumption, and nicotine dependence presented to the emergency department with involuntary movements of all limbs, headache, giddiness, fever, and a single seizure episode. On admission, his heart rate was 135 bpm, and serum sodium measured 118 mmol/L, confirming hyponatremia, while brain MRI revealed no acute intracranial pathology. A diagnosis of Carbamazepine-induced hyponatremia was established. The patient was promptly managed with intravenous Paracetamol, Thiamine, Levetiracetam, Ceftriaxone, and Tolvaptan, along with supportive therapy. Serum sodium levels normalized by the third day (138 mmol/L), and maintenance therapy included antiepileptic medication, gastric protection, and vitamin supplementation. He was discharged in stable condition with Quetiapine and vitamin therapy. This case highlights the importance of routine electrolyte monitoring in patients receiving prolonged Carbamazepine therapy, particularly those with chronic alcohol use, to prevent potential neurological complications associated with hyponatremia.

Keywords: Epilepsy, seizure, Carbamazepine induced hyponatremia, SIADH, Electrolyte disturbance and Tolvaptan.