Adelakun Adeniyi A, Choi Clara, Brensilver Jeffrey
Internal Medicine, The New York Medical College Graduate Medical Education Program at Saint Mary's General Hospital and Saint Clare's Health, Denville, USA.
Internal Medicine, Touro College of Osteopathic Medical School, New York, USA.
Cureus. 2024 Apr 17;16(4):e58493. doi: 10.7759/cureus.58493. eCollection 2024 Apr.
Hyponatremia, a common electrolyte disorder, usually has a benign clinical course. However, patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) can suffer unfavorable outcomes, including mortality. Atypical antipsychotics, which are among the drugs associated with SIADH, also cause tardive dyskinesia, a condition that physicians can now effectively manage with the recently approved agent - valbenazine. We herein report a case of severe hyponatremia due to SIADH in a 58-year-old man who developed hyponatremia-induced generalized seizures six weeks after valbenazine was added to his regimen to mitigate olanzapine-associated tardive dyskinesia. His electrolyte derangement and clinical course improved following prompt recognition and treatment of SIADH. The temporal association between the commencement of valbenazine and the onset of SIADH suggests a possible but previously unreported link between valbenazine and the development of SIADH. Awareness of this uncommon association is relevant to patient safety.
低钠血症是一种常见的电解质紊乱，通常临床病程良性。然而，抗利尿激素分泌异常综合征（SIADH）患者可能会出现不良后果，包括死亡。非典型抗精神病药物是与SIADH相关的药物之一，也会导致迟发性运动障碍，而医生现在可以使用最近获批的药物——缬苯那嗪有效治疗这种病症。我们在此报告一例58岁男性因SIADH导致严重低钠血症的病例，该患者在添加缬苯那嗪以减轻奥氮平相关迟发性运动障碍六周后，出现了低钠血症诱发的全身性癫痫发作。在及时识别和治疗SIADH后，他的电解质紊乱和临床病程得到改善。缬苯那嗪开始使用与SIADH发作之间的时间关联表明，缬苯那嗪与SIADH的发生之间可能存在一种此前未报告的联系。认识到这种不常见的关联对患者安全具有重要意义。
