trileptal, depakote and hyponatremia

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My 20 yr old daughter contracted encephylitus and suffered a stroke secondary when she was 8 yrs old...last 12 yrs have been chasing seizure control and we've been on every med. The last year has been better...she's taking Trileptal, Banzel and Valium...we recently added Depakote which she'd been on before. this past week, she suddenly fell into a state of unconciousness at school and was transported to ER...we discovered hyponatremia and a UTI. I'm very concerned...anyone experienced hyponatremia...her sodium level was 126.
Hi Coryt,

I took Trileptal once and ended up with hyponatremia. Definitely tell your daughter's neuro ASAP as hyponatremia is listed as a side effect of Trileptal.


Clinically significant hyponatremia (sodium <125 mmol/L) can develop during Trileptal use. In the 14 controlled epilepsy studies 2.5% of Trileptal-treated patients (38/1,524) had a sodium of less than 125 mmol/L at some point during treatment, compared to no such patients assigned placebo or active control (carbamazepine and phenobarbital for adjunctive and monotherapy substitution studies, and phenytoin and valproate for the monotherapy initiation studies). Clinically significant hyponatremia generally occurred during the first three months of treatment with Trileptal, although there were patients who first developed a serum sodium <125 mmol/L more than one year after initiation of therapy. Most patients who developed hyponatremia were asymptomatic but patients in the clinical trials were frequently monitored and some had their Trileptal dose reduced, discontinued, or had their fluid intake restricted for hyponatremia. Whether or not these maneuvers prevented the occurrence of more severe events is unknown. Cases of symptomatic hyponatremia have been reported during post-marketing use. In clinical trials, patients whose treatment with Trileptal was discontinued due to hyponatremia generally experienced normalization of serum sodium within a few days without additional treatment.

Measurement of serum sodium levels should be considered for patients during maintenance treatment with Trileptal, particularly if the patient is receiving other medications known to decrease serum sodium levels (for example, drugs associated with inappropriate ADH secretion) or if symptoms possibly indicating hyponatremia develop (e.g., nausea, malaise, headache, lethargy, confusion, obtundation, or increase in seizure frequency or severity).
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