2.3. 9. Polytherapy. Multiple drugs have been associated with an increased risk of hyponatremia, especially antipsychotics, antidepressants and antiepileptic [12], diuretics (mainly thiazides), ACEIs and NSAIDs.

In total, 87 cases of hyponatremia were identified from 630 adverse drug reactions. Six of these cases were patients who were using divalproex, or 6.9% of all hyponatremia cases. Each of the 6 patients who experienced severe hyponatremia were those using both DVP and another antiepileptic agent.

Hyponatremia is a very commonly encountered clinical entity with potentially dangerous effects and for which many precipitating factors have been identified. We present a case of valproic acid (VPA) overdose causing profound hyponatremia, with one of the lowest serum sodium levels ever documented in literature.

In elderly patients with a diet poor in protein and sodium, hyponatremia may be worsened by their low solute intake. The kidney’s need to excrete solutes aids in water excretion. An increase in dietary protein and salt can help improve water excretion.

All antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine.

Hyponatremia can result from multiple diseases that often are affecting the lungs, liver or brain, heart problems like congestive heart failure, or medications. Most people recover fully with their doctor’s help.

Current evidence suggests a relatively higher risk of hyponatremia with SSRIs and venlafaxine, especially when combined with patient risk factors, warranting clinicians to be aware of this complication.

Low blood sodium is common in older adults, especially those who are hospitalized or living in long-term care facilities. Signs and symptoms of hyponatremia can include altered personality, lethargy and confusion. Severe hyponatremia can cause seizures, coma and even death.

Severe hyponatremia occurs when levels drop below 125 mEq/L. Health issues arising from extremely low sodium levels may be fatal. Hyponatremia is the most common electrolyte disorder that doctors encounter. Research suggests that approximately 1.7 percent of people in the United States have the condition.

A low sodium level has many causes, including consumption of too many fluids, kidney failure, heart failure, cirrhosis, and use of diuretics. Symptoms result from brain dysfunction.

In patients with severe symptomatic hyponatremia, the rate of sodium correction should be 6 to 12 mEq per L in the first 24 hours and 18 mEq per L or less in 48 hours. A bolus of 100 to 150 mL of hypertonic 3% saline can be given to correct severe hyponatremia.

Treatment

1. Intravenous fluids. Your doctor may recommend IV sodium solution to slowly raise the sodium levels in your blood.
2. Medications. You may take medications to manage the signs and symptoms of hyponatremia, such as headaches, nausea and seizures.

The authors of the study report that hyponatremia symptoms can develop if a person drinks 3–4 liters of water in a short period, though they do not give a specific time estimate. According to one case report , soldiers developed symptoms after consuming at least 2 quarts (1.9 liters) of water per hour.

Low levels of salt in the diet may contribute to anxiety and help explain our persistent appetite for salty foods, indicates a new study on rats. The study, published in the journal Physiology & Behavior​, suggests that our high appetite for salty foods may be associated with coping with stress, depression and anxiety.

As well as weakness, fatigue, headache, nausea, vomiting and muscle cramps, confusion and irritability is a symptom of hyponatraemia (low sodium).

The authors subsequently discuss experiments in animals that look at brain changes associated with sodium deprivation, and studies in humans and animals that suggest that sodium deficiency can reduce the effect of usually pleasant and rewarding stimuli, and negatively affect mood.

Low-sodium diets can cause fitful sleep, researchers have found. In a study of nine men, the test subjects woke up more often during the night and slept less soundly when they were on low-sodium diets than when their diets included normal or high amounts of sodium, the researchers said.

Being deficient in vitamin D can lead to a host of sleep issues, including sleep disruption, insomnia, and overall poor sleep quality. “A deficiency in Vitamin D has been associated with many changes in sleep such as fewer sleeping hours, and sleep that is less restful and restorative,” said Dr.

A normal blood sodium level is between 135 and 145 milliequivalents per liter (mEq/L). Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L. Many possible conditions and lifestyle factors can lead to hyponatremia, including: Certain medications.