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Antipsychotics and severe hyponatremia: A Swedish population-based case-control study
Henrik Falhammar1, Jonatan D Lindh2, Jan Calissendorff1
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.
Antipsychotic medications are linked to a higher risk of hospitalization for hyponatremia, particularly first-generation antipsychotics (FGAs). However, specific drugs like risperidone showed no increased risk in this study.
Area of Science:
- Pharmacovigilance
- Clinical Pharmacology
- Internal Medicine
Background:
- Antipsychotics are associated with hyponatremia, but risks vary by drug class.
- Limited data exists on the comparative risk of first-generation (FGAs) versus second-generation antipsychotics (SGAs).
Purpose of the Study:
- To investigate the association between antipsychotic use and hospitalization for hyponatremia.
- To compare risks between FGAs and SGAs, and examine specific antipsychotics.
Main Methods:
- A Swedish population-based, case-control study.
- 14,359 hyponatremia hospitalizations compared to 57,383 controls.
- Multivariable logistic regression adjusted for confounders.
Main Results:
- Any antipsychotic use increased hyponatremia hospitalization risk (OR 1.67).
- FGAs posed a higher risk (OR 2.12) than SGAs (OR 1.32).
- Risperidone and aripiprazole showed no significant increased risk.
Conclusions:
- Antipsychotic therapy is associated with hyponatremia hospitalization.
- The risk is greater with FGAs than SGAs.
- Risperidone was not linked to an increased risk.
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