Hyponatremia induced by stable high dose risperidone in bipolar disorder: A case report

N.A. Uvais; T.P. Mohammed

doi:https://doi.org/10.25000/acem.398477

Article Details

Hyponatremia induced by stable high dose risperidone in bipolar disorder: A case report

Authors:

N.A. Uvais | T.P. Mohammed

Publisher:

Mustafa HASBAHÇECİ

Main Topics:

Diseases

Journal:

Archives of Clinical and Experimental Medicine 2018 Vol.3 Issue 2, pp.100-102

Document Type:

Article

Publication Date:

6/2018

Document Language:

English

Document ID (Org No.):

2000675749

Frequency:

Tri-annual

eISSN:

2564-6567

DOI:

https://doi.org/10.25000/acem.398477

Abstract:

 


Risperidone is a commonly prescribed
atypical antipsychotic. Hyponatremia has been reported rarely as an adverse
effect of risperidone. We report a case of a patient with bipolar affective
disorder, who developed the syndrome of inappropriate antidiuretic hormone
secretion, probably induced by high dose risperidone. A 60-year-old male with
bipolar affective disorder, who was on risperidone 6 mg per day and sodium
valproate 1200 mg per day, developed lethargy, unsteady gait, disorientation
for the past 4 days followed by fever and productive cough with yellow sputum.
Laboratory screening revealed that the serum sodium level was 117 mol/L, the
urine sodium concentration was 106 mmol/L and plasma
osmolarity was 260.57 mmol/Kg. A
diagnosis of the syndrome of inappropriate antidiuretic hormone
secretion was made. Risperidone was thought of as a
precipitating agent and changed over to olanzapine resulting in improvement in
hyponatremia. In this patient, high-dose risperidone treatment was the most
probable cause, and the mechanisms may be related to risperidone's high
affinity for the 5-hydroxytryptamine 2A and dopamine 2 receptors.


.

 


Risperidon genellikle kullanılan bir atipik antipsikotiktir.
Hiponatremi nadiren risperidonun bir yan etkisi olarak bildirilmiştir. Bipolar
affektif bozukluğu olan, uygunsuz antidiüretik hormon salınımı sendromu
gelişen, muhtemelen yüksek doz risperidonun neden olduğu bir hastayı sunuyoruz.
Bipolar duygulanım bozukluğu olan ve günde 6 mg risperidon ve günde 1200 mg
sodyum valproat kullanan 60 yaşındaki bir erkek hastada letarji, dengesiz
yürüme, son 4 gün boyunca yönelim bozukluğu, ardından ateş ve sarı balgamla karakterize
öksürük gelişti. Laboratuvar taraması sonucunda serum sodyum seviyesi 117
mmol/L, idrar sodyum konsantrasyonu 106 mmol/L idi ve plazma ozmolaritesi
260.57 mmol/Kg olarak hesaplandı. Uygunsuz antidiüretik hormon salınımı
sendromu olarak değerlendirildi. Risperidonun çökeltici bir madde olduğu
düşünülmüş ve tedavisi olanzapine değiştirilerek hiponatremisi düzeltilmiştir.
Bu hastada yüksek doz risperidon tedavisi en muhtemel neden olup, oluşum
mekanizması risperidonun 5-hidroksitriptamin 2A ve dopamin 2 reseptörlerine
yüksek afinitesi ile ilişkili olabilir.


.

Article Details

Hyponatremia induced by stable high dose risperidone in bipolar disorder: A case report

Authors: N.A. Uvais | T.P. Mohammed

Publisher: Mustafa HASBAHÇECİ

Main Topics: Diseases

Journal: Archives of Clinical and Experimental Medicine 2018 Vol.3 Issue 2, pp.100-102

Document Type: Article

Publication Date: 6/2018

Document Language: English

Document ID (Org No.): 2000675749

Frequency: Tri-annual

eISSN: 2564-6567

DOI: https://doi.org/10.25000/acem.398477

Issues

Authors:

N.A. Uvais | T.P. Mohammed

Publisher:

Mustafa HASBAHÇECİ

Main Topics:

Diseases

Journal:

Archives of Clinical and Experimental Medicine 2018 Vol.3 Issue 2, pp.100-102

Document Type:

Article

Publication Date:

6/2018

Document Language:

English

Document ID (Org No.):

2000675749

Frequency:

Tri-annual

eISSN:

2564-6567

DOI:

https://doi.org/10.25000/acem.398477