Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update
Hyponatremia (HN) is the most common electrolyte imbalance (defined as a serum sodium concentration Na(S) of
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| Veröffentlicht in: | Journal of Neural Transmission 2021-08, Vol.128 (8), p.1249-1264 |
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| container_title | Journal of Neural Transmission |
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| creator | Seifert, Johanna Letmaier, Martin Greiner, Timo Schneider, Michael Deest, Maximilian Eberlein, Christian K. Bleich, Stefan Grohmann, Renate Toto, Sermin |
| description | Hyponatremia (HN) is the most common electrolyte imbalance (defined as a serum sodium concentration Na(S) of |
| doi_str_mv | 10.1007/s00702-021-02369-1 |
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AMSP (Arzneimittelsicherheit in der Psychiatrie) is a multicenter drug surveillance program that assesses severe or unusual adverse drug reactions (ADRs) occurring during treatment with psychotropic drugs. This study presents data from 462,661 psychiatric inpatients treated in participating hospitals between 1993 and 2016 and serves as an update of a previous contribution by Letmaier et al. (JAMA 15(6):739–748, 2012). A total of 210 cases of HN were observed affecting 0.05% of patients. 57.1% of cases presented symptomatically; 19.0% presented with severe symptoms (e.g., seizures, vomiting). HN occurred after a median of 7 days following the first dose or dose increase. Incidence of HN was highest among the two antiepileptic drugs oxcarbazepine (1.661% of patients treated) and carbamazepine (0.169%), followed by selective serotonin-norepinephrine reuptake inhibitors (SSNRIs, 0.088%) and selective serotonin reuptake inhibitors (0.071%). Antipsychotic drugs, tricyclic antidepressants, and mirtazapine exhibited a significantly lower incidence of HN. The risk of HN was 16–42 times higher among patients concomitantly treated with other potentially HN-inducing drugs such as diuretic drugs, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and proton pump inhibitors. Female SSNRI-users aged ≥ 65 years concomitantly using other HN-inducing drugs were the population subgroup with the highest risk of developing HN. The identification of high-risk drug combinations and vulnerable patient subgroups represents a significant step in the improvement of drug safety and facilitates the implementation of precautionary measures.</description><identifier>ISSN: 0300-9564</identifier><identifier>EISSN: 1435-1463</identifier><identifier>DOI: 10.1007/s00702-021-02369-1</identifier><identifier>PMID: 34196782</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Medicine ; Medicine & Public Health ; Neurology ; Neurosciences ; Psychiatry ; Psychiatry and Preclinical Psychiatric Studies - Original ; Psychiatry and Preclinical Psychiatric Studies - Original Article</subject><ispartof>Journal of Neural Transmission, 2021-08, Vol.128 (8), p.1249-1264</ispartof><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c423t-32306c8c17967c644ee0fcb261f3ddf7d362109d1d7b74a7397c3783f5674adb3</citedby><cites>FETCH-LOGICAL-c423t-32306c8c17967c644ee0fcb261f3ddf7d362109d1d7b74a7397c3783f5674adb3</cites><orcidid>0000-0002-8678-7419</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00702-021-02369-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00702-021-02369-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids></links><search><creatorcontrib>Seifert, Johanna</creatorcontrib><creatorcontrib>Letmaier, Martin</creatorcontrib><creatorcontrib>Greiner, Timo</creatorcontrib><creatorcontrib>Schneider, Michael</creatorcontrib><creatorcontrib>Deest, Maximilian</creatorcontrib><creatorcontrib>Eberlein, Christian K.</creatorcontrib><creatorcontrib>Bleich, Stefan</creatorcontrib><creatorcontrib>Grohmann, Renate</creatorcontrib><creatorcontrib>Toto, Sermin</creatorcontrib><title>Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update</title><title>Journal of Neural Transmission</title><addtitle>J Neural Transm</addtitle><description>Hyponatremia (HN) is the most common electrolyte imbalance (defined as a serum sodium concentration Na(S) of < 130 mmol/l) and often induced by drugs including psychotropic drugs. AMSP (Arzneimittelsicherheit in der Psychiatrie) is a multicenter drug surveillance program that assesses severe or unusual adverse drug reactions (ADRs) occurring during treatment with psychotropic drugs. This study presents data from 462,661 psychiatric inpatients treated in participating hospitals between 1993 and 2016 and serves as an update of a previous contribution by Letmaier et al. (JAMA 15(6):739–748, 2012). A total of 210 cases of HN were observed affecting 0.05% of patients. 57.1% of cases presented symptomatically; 19.0% presented with severe symptoms (e.g., seizures, vomiting). HN occurred after a median of 7 days following the first dose or dose increase. Incidence of HN was highest among the two antiepileptic drugs oxcarbazepine (1.661% of patients treated) and carbamazepine (0.169%), followed by selective serotonin-norepinephrine reuptake inhibitors (SSNRIs, 0.088%) and selective serotonin reuptake inhibitors (0.071%). Antipsychotic drugs, tricyclic antidepressants, and mirtazapine exhibited a significantly lower incidence of HN. The risk of HN was 16–42 times higher among patients concomitantly treated with other potentially HN-inducing drugs such as diuretic drugs, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and proton pump inhibitors. Female SSNRI-users aged ≥ 65 years concomitantly using other HN-inducing drugs were the population subgroup with the highest risk of developing HN. The identification of high-risk drug combinations and vulnerable patient subgroups represents a significant step in the improvement of drug safety and facilitates the implementation of precautionary measures.</description><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Psychiatry</subject><subject>Psychiatry and Preclinical Psychiatric Studies - Original</subject><subject>Psychiatry and Preclinical Psychiatric Studies - Original Article</subject><issn>0300-9564</issn><issn>1435-1463</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><recordid>eNp9UU1P3DAQtaqi7kL7B3rKsZeUscexkx4qVQgKEhIc6K2S5bWd3aAkTu14pb3xH_iH_BK8LELqhYPHGs17bz4eIV8pfKcA8jTmAKwERvND0ZT0A1lSjlVJucCPZAkIUDaV4AtyHOM9AFAq609kgZw2QtZsSf7exp3Z-Dn4qTOFDWlddqNNxtlis5v8qOfghk7_KIKLqZ9j0QY_FPoFWcQUtq7rez0aV0zBr4Menh4e9VikyerZfSZHre6j-_L6n5A_F-d3Z5fl9c3vq7Nf16XhDOcSGYIwtaEyD2UE585Ba1ZM0BatbaVFwSg0llq5klxLbKRBWWNbiZzaFZ6QnwfdKa0GZ40b56B7NYVu0GGnvO7U_5Wx26i136oaGQPgWeDbq0Dw_5KLsxq6aNx-M-dTVKzissIGscpQdoCa4GMMrn1rQ0HtbVEHW1S2Rb3Yomgm4YEUM3hcu6DufQpjvsl7rGcObJHS</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Seifert, Johanna</creator><creator>Letmaier, Martin</creator><creator>Greiner, Timo</creator><creator>Schneider, Michael</creator><creator>Deest, Maximilian</creator><creator>Eberlein, Christian K.</creator><creator>Bleich, Stefan</creator><creator>Grohmann, Renate</creator><creator>Toto, Sermin</creator><general>Springer Vienna</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8678-7419</orcidid></search><sort><creationdate>20210801</creationdate><title>Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update</title><author>Seifert, Johanna ; Letmaier, Martin ; Greiner, Timo ; Schneider, Michael ; Deest, Maximilian ; Eberlein, Christian K. ; Bleich, Stefan ; Grohmann, Renate ; Toto, Sermin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c423t-32306c8c17967c644ee0fcb261f3ddf7d362109d1d7b74a7397c3783f5674adb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Psychiatry</topic><topic>Psychiatry and Preclinical Psychiatric Studies - Original</topic><topic>Psychiatry and Preclinical Psychiatric Studies - Original Article</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seifert, Johanna</creatorcontrib><creatorcontrib>Letmaier, Martin</creatorcontrib><creatorcontrib>Greiner, Timo</creatorcontrib><creatorcontrib>Schneider, Michael</creatorcontrib><creatorcontrib>Deest, Maximilian</creatorcontrib><creatorcontrib>Eberlein, Christian K.</creatorcontrib><creatorcontrib>Bleich, Stefan</creatorcontrib><creatorcontrib>Grohmann, Renate</creatorcontrib><creatorcontrib>Toto, Sermin</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of Neural Transmission</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seifert, Johanna</au><au>Letmaier, Martin</au><au>Greiner, Timo</au><au>Schneider, Michael</au><au>Deest, Maximilian</au><au>Eberlein, Christian K.</au><au>Bleich, Stefan</au><au>Grohmann, Renate</au><au>Toto, Sermin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update</atitle><jtitle>Journal of Neural Transmission</jtitle><stitle>J Neural Transm</stitle><date>2021-08-01</date><risdate>2021</risdate><volume>128</volume><issue>8</issue><spage>1249</spage><epage>1264</epage><pages>1249-1264</pages><issn>0300-9564</issn><eissn>1435-1463</eissn><abstract>Hyponatremia (HN) is the most common electrolyte imbalance (defined as a serum sodium concentration Na(S) of < 130 mmol/l) and often induced by drugs including psychotropic drugs. AMSP (Arzneimittelsicherheit in der Psychiatrie) is a multicenter drug surveillance program that assesses severe or unusual adverse drug reactions (ADRs) occurring during treatment with psychotropic drugs. This study presents data from 462,661 psychiatric inpatients treated in participating hospitals between 1993 and 2016 and serves as an update of a previous contribution by Letmaier et al. (JAMA 15(6):739–748, 2012). A total of 210 cases of HN were observed affecting 0.05% of patients. 57.1% of cases presented symptomatically; 19.0% presented with severe symptoms (e.g., seizures, vomiting). HN occurred after a median of 7 days following the first dose or dose increase. Incidence of HN was highest among the two antiepileptic drugs oxcarbazepine (1.661% of patients treated) and carbamazepine (0.169%), followed by selective serotonin-norepinephrine reuptake inhibitors (SSNRIs, 0.088%) and selective serotonin reuptake inhibitors (0.071%). Antipsychotic drugs, tricyclic antidepressants, and mirtazapine exhibited a significantly lower incidence of HN. The risk of HN was 16–42 times higher among patients concomitantly treated with other potentially HN-inducing drugs such as diuretic drugs, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and proton pump inhibitors. Female SSNRI-users aged ≥ 65 years concomitantly using other HN-inducing drugs were the population subgroup with the highest risk of developing HN. The identification of high-risk drug combinations and vulnerable patient subgroups represents a significant step in the improvement of drug safety and facilitates the implementation of precautionary measures.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>34196782</pmid><doi>10.1007/s00702-021-02369-1</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-8678-7419</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Medicine Medicine & Public Health Neurology Neurosciences Psychiatry Psychiatry and Preclinical Psychiatric Studies - Original Psychiatry and Preclinical Psychiatric Studies - Original Article |
| title | Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update |
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