{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:47:40Z","timestamp":1792176460567,"version":"4.4.0"},"reference-count":20,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T00:00:00Z","timestamp":1650326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Hyponatremia is one of the most common adverse effects in patients treated with oxcarbazepine (OXC). Different risk factors for OXC-induced hyponatremia have been described as age, female gender, dosage, and combination with other drugs During our clinical practice, we noticed that a longer duration of treatment with OXC could be associated with a higher risk of hyponatremia, therefore, in this study, we aimed to evaluate factors that may increase the risk of OXC-induced hyponatremia. Materials and Methods: Data were retrospectively collected from our clinical database at the Department of Neurology of the Hospital of Lithuanian University of Health Sciences Kaunas Clinics. The sample was divided into three groups: OXC consumers (n = 31), other anti-seizure medications (ASMs) consumers (n = 43), and controls absent ASMs (n = 31). All groups were matched by age and gender. Hyponatremia was defined as &lt;136 mmol\/L. Results: The frequency of hyponatremia was significantly higher among OXC patients (61.3%) compared to other ASM patients (5.4%) and controls (3.2%). The mean serum sodium concentration in the OXC group was 133.1 \u00b1 5.1 mmol\/L. The frequency of severe hyponatremia among OXC-treated patients was 19.4%; this subgroup was older than patients with moderate hyponatremia and normonatremia and had a longer OXC treatment duration compared to a subgroup of normonatremia. The average duration of OXC therapy was 8.7 \u00b1 5.5 years with a range from 1 to 21 years. Serum sodium concentration and duration of treatment with OXC demonstrated a significant negative correlation (r = \u22120,427, p = 0.017). Each year of therapy with OXC increased the risk of hyponatremia 1.3 times (OR = 1.326, 95% Cl 1.027\u20131.712, p = 0.031). Other factors (gender, age, polypharmacy, OXC dosage, and serum concentration) did not show a significant association with the development of hyponatremia. Conclusions: Longer duration of treatment with OXC is an important factor in the development and severity of hyponatremia.<\/jats:p>","DOI":"10.3390\/medicina58050559","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T02:39:31Z","timestamp":1650335971000},"page":"559","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Oxcarbazepine and Hyponatremia"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-7920","authenticated-orcid":false,"given":"Julija","family":"\u010ciau\u0161kait\u0117","sequence":"first","affiliation":[{"name":"Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevi\u010diaus Str. 9, LT 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giedr\u0117","family":"Gel\u017einien\u0117","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevi\u010diaus Str. 9, LT 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giedr\u0117","family":"Jurkevi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevi\u010diaus Str. 9, LT 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.seizure.2020.10.018","article-title":"Current role of carbamazepine and oxcarbazepine in the management of epilepsy","volume":"83","author":"Beydoun","year":"2020","journal-title":"Seizure"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1111\/epi.16069","article-title":"Serum sodium levels and related treatment-emergent adverse events during eslicarbazepine acetate use in adults with epilepsy","volume":"60","author":"Wechsler","year":"2019","journal-title":"Epilepsia"},{"key":"ref_3","first-page":"54","article-title":"Long-term effects of dibenzazepines on metabolic parameters: Retrospective comparison of carbamazepine, oxcarbazepine and eslicarbazepine acetate in the real world","volume":"71","author":"Ley","year":"2020","journal-title":"Rev. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.seizure.2013.11.015","article-title":"Frequency of and risk factors for oxcarbazepine-induced severe and symptomatic hyponatremia","volume":"23","author":"Kim","year":"2014","journal-title":"Seizure"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1177\/096032718900800501","article-title":"Hyponatraemia during Oxcarbazepine Therapy","volume":"8","author":"Pendlebury","year":"1989","journal-title":"Hum. Toxicol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/ana.10190","article-title":"Effects of oxcarbazepine on sodium concentration and water handling","volume":"51","author":"Sachdeo","year":"2002","journal-title":"Ann. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1111\/ene.13069","article-title":"Epidemiology, pathophysiology and putative genetic basis of carbamazepine- and oxcarbazepine-induced hyponatremia","volume":"23","author":"Berghuis","year":"2016","journal-title":"Eur. J. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1111\/epi.13777","article-title":"The EpiPGX Consortium Carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy","volume":"58","author":"Berghuis","year":"2017","journal-title":"Epilepsia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/WNF.0b013e3181f80bd4","article-title":"Risk Factors of Oxcarbazepine-Induced Hyponatremia in Patients with Epilepsy","volume":"33","author":"Lin","year":"2010","journal-title":"Clin. Neuropharmacol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1002\/epi4.12297","article-title":"A genome-wide association study of sodium levels and drug metabolism in an epilepsy cohort treated with carbamazepine and oxcarbazepine","volume":"4","author":"Berghuis","year":"2019","journal-title":"Epilepsia Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/14740338.2017.1248399","article-title":"Hyponatremia induced by antiepileptic drugs in patients with epilepsy","volume":"16","author":"Lu","year":"2017","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1111\/j.1528-1167.2009.02489.x","article-title":"Safety profile of oxcarbazepine: Results from a prescription-event monitoring study","volume":"51","author":"Buggy","year":"2010","journal-title":"Epilepsia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/0920-1211(88)90018-6","article-title":"Oxcarbazepine-induced hyponatremia, a cross-sectional study","volume":"2","author":"Nielsen","year":"1988","journal-title":"Epilepsy Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1212\/01.wnl.0000188819.45330.90","article-title":"Hyponatremia from oxcarbazepine and carbamazepine","volume":"65","author":"Dong","year":"2005","journal-title":"Neurology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1017\/S1461145711001192","article-title":"Hyponatraemia during psychopharmacological treatment: Results of a drug surveillance programme","volume":"15","author":"Letmaier","year":"2012","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.yebeh.2006.04.022","article-title":"Efficacy, safety, and tolerability of oxcarbazepine monotherapy","volume":"9","author":"Martinez","year":"2006","journal-title":"Epilepsy Behav."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/17446651.2019.1556095","article-title":"Management of hyponatremia: Causes, clinical aspects, differential diagnosis and treatment","volume":"14","author":"Peri","year":"2019","journal-title":"Expert Rev. Endocrinol. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1111\/epi.16828","article-title":"Symptomatology of carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy","volume":"62","author":"Berghuis","year":"2021","journal-title":"Epilepsia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2268","DOI":"10.2215\/CJN.00170115","article-title":"Mild Chronic Hyponatremia in the Ambulatory Setting: Significance and Management","volume":"10","author":"Berl","year":"2015","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e13022","DOI":"10.1111\/eci.13022","article-title":"Impact of chronic hyponatremia on neurocognitive and neuromuscular function","volume":"48","author":"Refardt","year":"2018","journal-title":"Eur. J. Clin. Investig."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/559\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:56:21Z","timestamp":1760136981000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,19]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["medicina58050559"],"URL":"https:\/\/doi.org\/10.3390\/medicina58050559","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,19]]}}}