Does divalproex cause hyponatremia? In total, 87 cases of hyponatremia were identified from 630 adverse drug reactions. Six of these cases were patients who were using divalproex, or 6.9% of all hyponatremia cases . Each of the 6 patients who experienced severe hyponatremia were those using both DVP and another antiepileptic agent.
Does Depakote cause hyponatremia?
Administration of high doses of the mood stabilizer and antiepileptic drug sodium valproate can cause an SIADH-like syndrome with hyponatremia . We recommend that sodium levels be monitored regularly during administration of high doses of sodium valproate.
Which drugs can cause hyponatremia?
Summary. Drug-induced hyponatraemia is commonly associated with diuretics, selective serotonin reuptake inhibitors and antiepileptics .
What medications should be avoided with hyponatremia?
What psych meds cause hyponatremia?
Atypical antipsychotics (aripiprazole, quetiapine, clozapine) cause hyponatremia due to their serotonin-mediated effects on central 5-HT2 and 5-HT1c receptors which lead to excess release of ADH. Furthermore, serotonin is known to reset the osmostat and thereby lowers the threshold for ADH secretion.
What are side effects of divalproex?
A: Common side effects experienced with Depakote include drowsiness, nausea, abdominal pain, diarrhea, vomiting, low platelet count, tremors, tiredness, and hair loss . The side effects may be mild to moderate, but they may also be signs of a more serious condition.
Is there sodium in Depakote?
Divalproex sodium is a stable coordination compound comprised of sodium valproate and valproic acid used to treat manic episodes associated with bipolar disorder, epilepsy, and migraine headaches. Divalproex sodium is available under the following different brand names: Depakote, Depakote ER, and Depakote Sprinkles.
What is the most common cause of hyponatremia?
Hyponatremia is decrease in serum sodium concentration < 136 mEq/L (< 136 mmol/L) caused by an excess of water relative to solute. Common causes include diuretic use, diarrhea, heart failure, liver disease, renal disease, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) .
What antidepressants can cause low sodium?
Conclusion: Hyponatremia is a potentially dangerous side effect of antidepressants and is not exclusive to SSRIs. Current evidence suggests a relatively higher risk of hyponatremia with SSRIs and venlafaxine , especially when combined with patient risk factors, warranting clinicians to be aware of this complication.
Which antidepressant is least likely to cause hyponatremia?
Conclusions. All antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine .
What is a dangerously low sodium level?
The definition of a low sodium level is below 135 milliequivalents per liter (meq/l). Severe hyponatremia occurs when levels drop below 125 meq/l . Health issues arising from extremely low sodium levels may be fatal.
How do you reverse hyponatremia?
- Intravenous fluids. Your doctor may recommend IV sodium solution to slowly raise the sodium levels in your blood. ...
- Medications. You may take medications to manage the signs and symptoms of hyponatremia, such as headaches, nausea and seizures.
Will eating more salt help hyponatremia?
In elderly patients with a diet poor in protein and sodium, hyponatremia may be worsened by their low solute intake. The kidney’s need to excrete solutes aids in water excretion. An increase in dietary protein and salt can help improve water excretion .
Which antipsychotic is least likely to cause hyponatremia?
Currently, there are no reliable estimates of incidence or risk of hyponatremia from atypical antipsychotic drugs ( risperidone, olanzapine, and quetiapine ) in older adults. To date, only one case-control study has examined the association between atypical antipsychotic drug use and hyponatremia [17].
Is 128 a low sodium level?
Your blood sodium level is normal if it’s 135 to 145 milliequivalents per liter (mEq/L). If it’s below 135 mEq/L, it’s hyponatremia .
What are the side effects of divalproex sodium 500 mg?
- Diarrhea, dizziness, drowsiness, hair loss, blurred/double vision, change in menstrual periods, ringing in the ears, shakiness (tremor), unsteadiness, weight changes may occur. ...
- You may rarely see partial tablets in your stool.
What is the difference between divalproex and Depakote?
Depakote is the brand name for divalproex sodium . This medication is available as a delayed-release (DR) tablet, an extended-release (ER) tablet, and a DR “sprinkle” capsule. The sprinkle capsule gets its name from the fact that you can open the capsule and sprinkle it onto soft food.
Who should not take divalproex?
Is divalproex a salt?
What happens if you take too much divalproex?
If you stop taking it suddenly: If you’re taking this drug to treat seizures, stopping it suddenly can cause a seizure that won’t stop (status epilepticus). If you take too much: Taking too much of this drug can cause dangerous effects, such as: extreme fatigue .
How much divalproex is too much?
The maximum recommended dosage is 60 mg/kg/day . The recommended starting dose of divalproex for the prevention of migraine is 250 mg twice daily. The dose may be increased until migraine control is achieved. The maximum recommended dose is 1000 mg/day as needed.
Which organ is most affected by hyponatremia?
Hyponatremia occurs when your blood sodium level goes below 135 mEq/L. When the sodium level in your blood is too low, extra water goes into your cells and makes them swell. This swelling can be dangerous especially in the brain , since the brain cannot expand past the skull.
At what level does hyponatremia become symptomatic?
What are 3 types of hyponatremia?
Hypovolemic hyponatremia : decrease in total body water with greater decrease in total body sodium. Euvolemic hyponatremia: normal body sodium with increase in total body water. Hypervolemic hyponatremia: increase in total body sodium with greater increase in total body water.
What is the best antidepressant option for an elderly patient with history of chronic hyponatremia?
In patients at risk for or with a history of antidepressant-induced hyponatremia, bupropion may be the most appropriate antidepressant treatment. Mirtazapine could be also used alternatively because the associated risk of hyponatremia is moderate.
What symptoms does low sodium cause?
Low blood sodium is common in older adults, especially those who are hospitalized or living in long-term care facilities. Signs and symptoms of hyponatremia can include altered personality, lethargy and confusion . Severe hyponatremia can cause seizures, coma and even death.
What Causes low sodium?
What is the safest antidepressant to take?
Among the newer antidepressants, bupropion and venlafaxine were associated with the highest case fatality rates. In addition, among SSRIs, citalopram and fluvoxamine appeared to be related to higher mortality rates in overdose, whereas fluoxetine and sertraline were the safest [188].
Does Zoloft cause hyponatremia?
What is the safest SSRI for anxiety?
What happens if your sodium level is 125?
Any value below 135 mEq/L is considered to be a low sodium level, a condition medically referred to as hyponatremia. As sodium levels drop to 125 mEq/L, the situation becomes more serious . And when the sodium level drops to 115 mEq/L or below, the situation is critical and requires immediate treatment.
How long does it take to recover from hyponatremia?
What happens if your sodium level is 120?
Hyponatremia is the most common electrolyte abnormality in hospitalized patients, and it increases the likelihood of a hospital death (1–5). Inpatient mortality rates as high as 50% or more have been reported for patients with serum sodium concentrations (sNa) <120 mEq/L (6–9).
What are the long term effects of taking Depakote?
Pancreatitis (swelling and damage of the pancreas) has also been reported, including in people who’ve taken Depakote for years. Liver damage and pancreatitis are long-term side effects. Depakote and Depakote ER have a boxed warning for risk of liver damage and pancreatitis.
Does valproic acid cause SIADH?
Valproic acid use could lead to reduced sensitivity of hypothalamic osmoreceptors. It also might directly affect tubular cell function, thereby leading to SIADH .
Does olanzapine cause hyponatremia?
Rapid-onset hyponatremia is a rare, but potential, complication of olanzapine treatment . Hyponatremia, secondary to atypical antipsychotic use, has been reported in many case reports and is thought to be associated with a syndrome of inappropriate anti-diuretic hormone secretion (SIADH).
