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      Hyponatremia Possible Consequence Oxcarbazepine Therapy In Children

      A DGReview of :"Oxcarbazepine-induced hyponatremia and the regulation of serum sodium after replacing carbamazepine with oxcarbazepine in children."
      Neuropediatrics

      03/17/2003
      By Alison Palkhivala


      Hyponatremia can develop in children taking oxcarbazepine for the treatment of epilepsy, although the condition is generally subclinical.

      To determine whether hyponatremia is a potential problem in children treated with oxcarbazepine, researchers measured serum electrolyte balances in 75 children with epilepsy before and after taking the drug and after replacing carbamazepine therapy with oxcarbazepine. The investigators were led by M. Holtmann from the department of child and adolescent psychiatry and psychotherapy, Central Institute of Mental Health, Manheim, Germany.

      Prior to starting oxcarbazepine therapy, all the children had normal serum sodium levels. During the treatment, 26.6% of the children developed hyponatremia, defined as Na+ ion levels under 135 mmol/L, without clinical symptoms. Two children developed sodium levels under 125 mmol/L, and one child developed clinically relevant hyponatremia.

      Among the 27 children in whom carbamazepine was replaced with oxcarbazepine, one child developed hyponatremia without symptoms while taking carbamazepine, and six developed it while taking oxcarbazepine.

      The dosage of oxcarbazepine taken did not influence the incidence of hyponatremia, nor did serum levels of the active metabolite of this drug, anti-epileptic comediation, age or gender.

      Based on these findings, the authors recommended that electrolytes be tested in children before they take oxcarbazepine and again while they are on the drug, if symptoms occur.
      Neuropediatrics 2002 Dec;33:6:298-300. "Oxcarbazepine-induced hyponatremia and the regulation of serum sodium after replacing carbamazepine with oxcarbazepine in children."

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