Hyponatremia following esclicarbazepine therapy

To evaluate the safety of eslicarbazepine acetate (ESL) in new onset elderly poststroke seizure patients, especially with respect to hyponatremia.

In a two year, single center open labeled observational study of ESL in patients with imaging proven stroke with new onset post stroke seizure were included. ESL was titrated between 400mg and 1200 mg once daily during 1 month observation period. The titrated dose of ESL was continued during 96-week maintenance period. The patients were followed up for seizure control and side effects, including serum sodium on first examination, at the end of 1 month and then at three monthly intervals for 24 months (total eight visits).

Hyponatremia developed in four out of 32 (12.5%) patients; it was symptomatic in three and asymptomatic in one patient. No statistically significant difference between mean sodium levels at different time period, compared to baseline was found.

High incidence of hyponatremia in ESL treated post stroke patients, was found, hyponatremia symptoms since can be subtle and delayed, so monitoring of serum sodium in the patients on ESL treatment is recommended especially in elderly.