Carbamazepine
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Reactions 569 - 23 Sep 1995 Carbamazepine Hyponatraemia: case report Carbamazepine-induced hyponatraemia can be successfully reversed with concomitant doxycyline, as described in the following case report. A 38-year-old woman with a history of schizoaffective disorder and hypothyroidism was admitted with psychotic symptoms and delusions. On admission (day 1), her medications comprised oral carbamazepine 200mg tid, fluphenazine, clonazepam, benzatropine and levothyroxine. However, she had a history of noncompliance, and her plasma carbamazepine concentration on day 1 was 0.1 ng/ml (therapeutic range 5–10 ng/ml). Her serum sodium level was 136mEq/L and she had normal thyroid function. The woman’s medications were restarted and on day 21, with a carbamazepine dosage of 1000 mg/day, her serum carbamazepine concentration was 8.4 ng/ml. Her serum sodium level was 129 mEq/L. Two days later, her serum sodium level had decreased to 125 mEq/L, but she remained asymptomatic. On day 26, the woman started therapy with oral doxycycline 100mg bid for a cervical infection and the following day, her serum carbamazepine concentration was 6.9 ng/ml and her serum sodium level was 131 mEq/L. Two days later, these parameters were 8.1 ng/ml and 132 mEq/L, respectively. The patient completed doxycyline therapy on day 32 and on day 35, her serum sodium level had decreased to 125 mEq/L. Carbamazepine was tapered and replaced with valproic acid therapy and her serum sodium level normalised. Author comment: Another tetracycline antibacterial agent, demeclocycline has been shown to correct carbamazepine- induced hyponatraemia. However, doxycyline may be a useful alternative treatment, since it has a longer half-life and does not cause renal toxicity. Boutros NN, et al. Carbamazepine-induced hyponatremia resolved with doxycycline. Journal of Clinical Psychiatry 56: 377-378, Aug 1995 - USA 800389906 1 Reactions 23 Sep 1995 No. 569 0114-9954/10/0569-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 569 - 23 Sep 1995
Carbamazepine
Hyponatraemia: case reportCarbamazepine-induced hyponatraemia can be successfully
reversed with concomitant doxycyline, as described in thefollowing case report.
A 38-year-old woman with a history of schizoaffectivedisorder and hypothyroidism was admitted with psychoticsymptoms and delusions. On admission (day 1), hermedications comprised oral carbamazepine 200mg tid,fluphenazine, clonazepam, benzatropine and levothyroxine.However, she had a history of noncompliance, and her plasmacarbamazepine concentration on day 1 was 0.1 ng/ml(therapeutic range 5–10 ng/ml). Her serum sodium level was136mEq/L and she had normal thyroid function.
The woman’s medications were restarted and on day 21,with a carbamazepine dosage of 1000 mg/day, her serumcarbamazepine concentration was 8.4 ng/ml. Her serumsodium level was 129 mEq/L. Two days later, her serumsodium level had decreased to 125 mEq/L, but she remainedasymptomatic. On day 26, the woman started therapy withoral doxycycline 100mg bid for a cervical infection and thefollowing day, her serum carbamazepine concentration was6.9 ng/ml and her serum sodium level was 131 mEq/L. Twodays later, these parameters were 8.1 ng/ml and 132 mEq/L,respectively.
The patient completed doxycyline therapy on day 32 and onday 35, her serum sodium level had decreased to 125 mEq/L.Carbamazepine was tapered and replaced with valproic acidtherapy and her serum sodium level normalised.
Author comment: Another tetracycline antibacterial agent,demeclocycline has been shown to correct carbamazepine-induced hyponatraemia. However, doxycyline may be a usefulalternative treatment, since it has a longer half-life and does notcause renal toxicity.Boutros NN, et al. Carbamazepine-induced hyponatremia resolved withdoxycycline. Journal of Clinical Psychiatry 56: 377-378, Aug 1995 -USA 800389906
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Reactions 23 Sep 1995 No. 5690114-9954/10/0569-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
