Auto-aggressiveness due to oxcarbazepine induced hyponatremia: A case report

Abstract

Oxcarbazepine, like many other antiepileptic drugs, is a widely and frequently off-label medicine prescribed by psychiatrists to decrease impulsivity and behavior disturbances. It is known that it increases the risk of developing hyponatremia. Although most patients with hyponatremia are asymptomatic, adverse effects could vary from mild to severe (respiratory failure) or even fatal (death). There are limited data for oxcarbazepine-induced symptomatic hyponatremia. Case presentation: We describe the case of a 64-year-old patient with intellectual disabilities who developed agitation and auto-aggressiveness due to hyponatremia secondary to taking oxcarbazepine. Those behavior disturbances and hyponatremia were resolved upon monitoring blood sodium level and stopping oxcarbazepine. Conclusions: Hyponatremia is a frequent adverse effect, most times asymptomatic. We report a case of agitation and auto-aggressiveness due to it and induced by oxcarbazepine. To reduce this secondary effect and its potential consequences, it should be considered by psychiatrists as a clinical entity and a possible cause of abnormal behavior. We suggest monitoring serum sodium when prescribed.