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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Hyponatremia Be Treated?

After being diagnosed with a seizure disorder any many years ago, I was prescribed Trileptal (Oxcarbazapine). Like many others who have used this medication, I developed hyponatremia. More properly: SIADH. I was finally switched to Depacote ER (Divalproex Sodium). I have permanently lost my sense of thirst, and since I really do not show any of the more obvious effects of dehydration, I'm never thirsty--even now almost a decade of being off Trileptal. I'm not as interested in a response as I am in bringing this peculiarity to your attention.
Mon, 6 Nov 2017
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Ayurveda Specialist,  's  Response
**
Thanks for contacting with your health concern.

1. hyponatremia is a documented ADR [adverse drug reaction] of oxcarbazepine and because of that you developed SIADH for which treatment depends upon the following parameters:

i. As you are asymptomatic [not feeling any effects of dehydration], it may be presumed that the condition is chronic, thus consultation with a Nephrologist is essential to prevent any disastrous consequences [because of any inappropriate approach by physicians from another speciality.

ii. The urine osmolality and creatinine clearance must be considered when choosing the type of therapy. [as the case is chronic thus limit rate of correction [fluid restriction and hypertonic saline]

iii. Since it is an electrolyte disorder, thus it has to be remembered that in any therapy of chronic SIADH it is important to limit the daily increase of serum sodium to less than 8–10 mmol/liter because higher correction rates have been associated with osmotic demyelination.

PS. Your prognosis will depend on the cause of SIADH. Any underlying medical conditions must be treated.


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How Can Hyponatremia Be Treated?

** Thanks for contacting with your health concern. 1. hyponatremia is a documented ADR [adverse drug reaction] of oxcarbazepine and because of that you developed SIADH for which treatment depends upon the following parameters: i. As you are asymptomatic [not feeling any effects of dehydration], it may be presumed that the condition is chronic, thus consultation with a Nephrologist is essential to prevent any disastrous consequences [because of any inappropriate approach by physicians from another speciality. ii. The urine osmolality and creatinine clearance must be considered when choosing the type of therapy. [as the case is chronic thus limit rate of correction [fluid restriction and hypertonic saline] iii. Since it is an electrolyte disorder, thus it has to be remembered that in any therapy of chronic SIADH it is important to limit the daily increase of serum sodium to less than 8–10 mmol/liter because higher correction rates have been associated with osmotic demyelination. PS. Your prognosis will depend on the cause of SIADH. Any underlying medical conditions must be treated.