Antipsychotic induced hyponatremia: Clinical case report

Akvilė Gaupšaitė1

1Vilnius University, Faculty of Medicine


Introduction. Antipsychotics are one of the most commonly used medications in a psychiatric practice treating acute or chronic psychotic disorders. They often cause various adverse drug reactions (ADR), such as extrapyramidal symptoms, parkinsonism or metabolic syndrome. However, there is an increasing number of clinical cases of antipsychotic-induced hyponatremia, requiring hospitalization.

Clinical case: we report the clinical case of a 52 year old  patient with paranoid schizophrenia who has been taking antipsychotic medication for more than 5 years. He was admitted to the emergency department after a first tonic-clonic seizure due to severe hyponatremia. The patient was diagnosed with impaired antidiuretic hormone secretion syndrome, possibly caused by antipsychotic medications.

Literature review: hyponatremia is one of the most common electrolyte disorders that afflict hospitalized patients. There are an increasing number of clinical cases where antipsychotics cause this electrolyte imbalance. One of the possible mechanisms for the development of hyponatremia is the syndrome of impaired antidiuretic hormone secretion, although further research on this topic remains needed.

Conclusion: this case, like many others, highlights the gap in the outpatient treatment of psychiatric illnesses and the need to periodically monitor patients’ blood electrolytes or change treatment in a timely manner when prescribing antipsychotics.

Keywords: antipsychotics, hyponatremia, syndrome of inappropriate antidiuretic hormone secretion.