Evaluation of Serum Sodium Alterations in Patients Receiving Carbamazepine Therapy: A Prospective Observational Study

Abstract

Background: Carbamazepine is a widely used antiepileptic drug with established efficacy in epilepsy, trigeminal neuralgia, and bipolar disorder. However, it is frequently associated with electrolyte disturbances, particularly hyponatremia, due to its antidiuretic hormone-like effects. Hyponatremia can lead to significant clinical consequences ranging from mild symptoms to severe neurological complications.

Aim: To evaluate serum sodium alterations in patients receiving carbamazepine therapy and to determine the incidence and severity of hyponatremia.

Methods: A prospective observational study was conducted on 100 patients receiving carbamazepine therapy in a tertiary care center. Serum sodium levels were measured and categorized as normal (135–145 mEq/L), mild hyponatremia (130–134 mEq/L), moderate (125–129 mEq/L), and severe (<125 mEq/L). Associations with duration of therapy and age were analyzed.

Results: Among 100 patients, 62% had normal sodium levels, while 38% developed hyponatremia. Mild hyponatremia was observed in 20%, moderate in 12%, and severe in 6% of patients. Hyponatremia was more frequent in patients receiving therapy for more than 6 months and in elderly individuals. A statistically significant association was observed between duration of therapy and sodium levels (p < 0.05).

Conclusion: Carbamazepine therapy is associated with a significant incidence of hyponatremia, particularly in long-term use and elderly patients. Regular monitoring of serum sodium is essential to prevent complications.