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Epidemiology,pathophysiology and putative genetic basis of carbamazepine‐ and oxcarbazepine‐induced hyponatremia
Authors:B. Berghuis  G.‐J. de Haan  M. P. H. van den Broek  J. W. Sander  D. Lindhout  B. P. C. Koeleman
Affiliation:1. Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands;2. Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands;3. UCL Institute of Neurology, NIHR UCL Hospitals Biomedical Research Centre, London, UK;4. Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
Abstract:The use of carbamazepine (CBZ) and oxcarbazepine (OXC) as first‐line antiepileptic drugs in the treatment of focal epilepsy is limited by hyponatremia, a known adverse effect. Hyponatremia occurs in up to half of people taking CBZ or OXC and, although often assumed to be asymptomatic, it can lead to symptoms ranging from unsteadiness and mild confusion to seizures and coma. Hyponatremia is probably due to the antidiuretic properties of CBZ and OXC that are, at least partly, explained by stimulation of the vasopressin 2 receptor/aquaporin 2 pathway. No known genetic risk variants for CBZ‐ and OXC‐induced hyponatremia exist, but likely candidate genes are part of the vasopressin water reabsorption pathway.
Keywords:antiepileptic drugs  drug treatment  epilepsy  sodium  vasopressin receptor 2
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