Highlights
- •There was an association between antipsychotics, and hospitalization due to hyponatremia
- •The association was stronger for first-generation than second-generation antipsychotics
- •Risperidone was not associated with an increased risk
- •In severe hyponatremia with antipsychotics, consider an alternative
- •If the indication for antipsychotic use remains, risperidone could here be an option
Abstract
Background
Antipsychotics have been claimed to cause hyponatremia. The risk associated with individual
antipsychotics, or groups (first-generation [FGAs] or second-generation [SGAs] antipsychotics),
is not well-documented. The objective of this study was to investigate the association
between antipsychotics and hospitalization due to hyponatremia.
Methods
The general Swedish population was the base of this register–based case–control study.
Comparisons were made between patients hospitalized with a principal diagnosis of
hyponatremia (n = 14,359) and matched controls (n = 57,383). Multivariable logistic regression adjusting for concomitant drugs, medical
conditions, previous hospitalizations and socioeconomic factors was performed to investigate
the association between hyponatremia and antipsychotic use. In addition newly initiated
(≤90 days) or ongoing use was analysed separately.
Results
Compared to controls, the adjusted OR (95%CI) for hospitalization due to hyponatremia
was for any antipsychotic 1.67(1.5–1.86). Individuals on FGA were more likely to experience
severe hyponatremia (2.12[1.83–2.46]) than those on any SGA (1.32[1.15–1.51]). No
increased risks, neither as newly initiated nor ongoing therapy, were found for risperidone
(0.86[0.56–1.31] and 0.83[0.67–1.02]) and aripiprazole (1.16[0.30–4.46] and 0.62[0.27–1.34]),
respectively.
Conclusions
There was an association between antipsychotic therapy and hospitalization due to
hyponatremia. The association was stronger for FGAs than SGAs. Risperidone was not
associated with an increased risk.
Keywords
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Article info
Publication history
Published online: December 01, 2018
Accepted:
November 27,
2018
Received in revised form:
November 24,
2018
Received:
October 2,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Corrigendum to: Antipsychotics and severe hyponatremia: A Swedish population-based case-control study. Eur J Intern Med. 2019 Feb;60:71-77.European Journal of Internal MedicineVol. 92
- PreviewThe authors regret that in preparation of a new article based on the same data as in the previous published article [1], we unfortunately discovered two errors in the dataset. Some cases of hyponatremia as a secondary diagnosis had erroneously been included as primary diagnosis of hyponatremia. The corrected number of cases admitted with a primary diagnosis of hyponatremia decreased to 11,213 instead of 14,359 as reported in the article, and as a consequence the number of matched controls decreased to 44,801 instead of 57,382.
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