Editorial | DOI: https://doi.org/10.31579/2768-2757/154
1 Hatay Mustafa Kemal University, Faculty of Medicine, Emergency Medicine, Hatay, Turkey.
2 Hatay Mustafa Kemal University, Faculty of Medicine, Department of Emergency Medicine.
*Corresponding Author: Ali Karakuş, Hatay Mustafa Kemal University, Faculty of Medicine, Emergency Medicine, Hatay, Turkey.
Citation: Pınar B Yücel, Amro M Hafeth, Polat M., Ali Karakuş, (2025555), Hyponatremia With Carbamazepine Intoxication, Journal of Clinical Surgery and Research, 6(1); DOI:10.31579/2768-2757/154
Copyright: © 2025, Ali Karakuş. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 07 November 2024 | Accepted: 05 December 2024 | Published: 17 January 2025
Keywords: carbamazepine; seizure; coma; hyponatremia
Carbamazepine is one of the anticonvulsant drugs that is frequently used in the treatment of epilepsy and is known to be safe. Although it is safe, it sometimes causes serious toxicity and even death. In addition to its pharmacological effects such as sedation, anticholinergic, antidepressant and antidiuretic, carbamazepine causes serious hyponatremia.
Carbamazepine is one of the anticonvulsant drugs that is frequently used in the treatment of epilepsy and is known to be safe. Although it is safe, it sometimes causes serious toxicity and even death. In addition to its pharmacological effects such as sedation, anticholinergic, antidepressant and antidiuretic, carbamazepine causes serious hyponatremia. In adults, values above 40ug/ml cause serious toxicities such as coma, respiratory depression and dysrhythmias.
A 47-year-old male patient diagnosed with epilepsy became unconscious after taking 40 doses of carbamazepine for suicide, which he used for treatment. The patient was referred to us from an external center on 112 because of seizures. He was in a coma, his general condition was poor, glaskow coma score(GCS)3 hours 98, pulse 90/min blood pressure 160. /90mmHg respiratory rate 22/min. Light reflexes were taken bilaterally. The patient in the coma clinic was intubated. A nasogastric tube was inserted and activated charcoal was administered at a dose of 1g/kg. While
all blood results of the patient were within normal limits, sodium was seen as 122mmol/L. Our patient was admitted to the anesthesia and reanimation intensive care unit and appropriate fluid therapy and repeated doses of activated charcoal were administered, and he was followed up. The patient was followed up in the intensive care unit for 4 days, and his control sodium levels were observed as 125mmmol/l-127mmol/l-129mmol/l-130mmol/l, respectively. His clinical findings started to improve after the 3rd day, and as a result of his GCS increasing to 15, he was extubated and admitted to the psychiatric ward on the 4th day, where he was monitored for 1 week and then discharged with full recovery.
Due to frequent use of carbamezepine, poisoning occurs very frequently. It should be kept in mind that its antidiuretic effect will cause hyponatremia, loss of consciousness and seizures.
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