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Last edited on December 27, 2021

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--- cl:hyponatremia [on April 25, 2019]
+++ cl:hyponatremia [on April 25, 2020]
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 ====== Hyponatremia ======
+{{INLINETOC}}
 ===== Primer =====
 **Hyponatremia** is an electrolyte disturbance of low serum sodium that can result in neuropsychiatric symptoms. In psychiatric patients, the cause of hyponatremia is most commonly secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) from psychotropics medications including [[meds:antidepressants:home|antidepressants]] and [[meds:antipsychotics:home|antipsychotics]].
+== Definition ==
+Hyponatremia is defined by a serum sodium ([Na+]) concentration less than 136 mEq/L (1 mEq/L = 1 mmol/L). This indicates an excess of water relative to sodium in the extracellular fluid compartment (ECF). The normal range of serum sodium can range from 135 to 145 mEq/L.
 <callout type="question" title="Why does Hyponatremia Matter in Psychiatry?" icon="true">
 Hyponatremia is frequently underdiagnosed and undertreated in both general medicine and psychiatric patients.[([[https://www.ncbi.nlm.nih.gov/pubmed/18306096|Siegel, A. J. (2008). Hyponatremia in psychiatric patients: update on evaluation and management. Harvard review of psychiatry, 16(1), 13-24.]])] Like with other electrolyte and fluid imbalances (see also: [[cl:hypokalemia|hypokalemia]], [[cl:hypomagnesemia|hypomagnesemia]], [[cl:hypocalcemia|hypocalcemia]], [[cl:hypercalcemia-hyperparathyroidism|hypercalcemia]]),[([[https://www.ncbi.nlm.nih.gov/pubmed/7220784|Webb Jr, W. L., & Gehi, M. (1981). Electrolyte and fluid imbalance: neuropsychiatric manifestations. Psychosomatics, 22(3), 199-203.]])] hyponatremia can cause neuropsychiatric symptoms. Acute-onset hyponatremia can cause delirium and acute behavioural changes that can be mistaken for symptoms of a psychiatric disorder. Other causes of hyponatremia, such as SIADH, may resemble psychiatric disorders or the adverse effects of psychotropic drugs, and the diagnosis of SIADH can be delayed for psychiatric patients.
 </callout>
-== Definition ==
-Hyponatremia is defined by a serum sodium ([Na+]) concentration less than 136 mEq/L (1 mEq/L = 1 mmol/L). This indicates an excess of water relative to sodium in the extracellular fluid compartment (ECF). The normal range of serum sodium can range from 135 to 145 mEq/L.
 ===== Symptoms =====
-Early signs and symptoms of hyponatremia includes nausea, vomiting, anorexia, disorientation, headache, fatigue, weakness, irritability, lethargy, confusion, and muscle cramps.[([[https://www.ncbi.nlm.nih.gov/pubmed/7220784|Webb Jr, W. L., & Gehi, M. (1981). Electrolyte and fluid imbalance: neuropsychiatric manifestations. Psychosomatics, 22(3), 199-203.]])] Falls and confusion in the due to hyponatremia is common in the elderly.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110800/|Soiza, R. L., & Talbot, H. S. (2011). Management of hyponatraemia in older people: old threats and new opportunities. Therapeutic advances in drug safety, 2(1), 9-17.]])] With severe hyponatremia, [[neurology:approaches:seizures|seizures]] can develop.
+Early signs and symptoms of hyponatremia includes nausea, vomiting, anorexia, disorientation, headache, fatigue, weakness, irritability, lethargy, confusion, and muscle cramps.[([[https://www.ncbi.nlm.nih.gov/pubmed/7220784|Webb Jr, W. L., & Gehi, M. (1981). Electrolyte and fluid imbalance: neuropsychiatric manifestations. Psychosomatics, 22(3), 199-203.]])] Falls and confusion in the due to hyponatremia is common in the elderly.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110800/|Soiza, R. L., & Talbot, H. S. (2011). Management of hyponatraemia in older people: old threats and new opportunities. Therapeutic advances in drug safety, 2(1), 9-17.]])] With severe hyponatremia, [[neurology:approach-seizures|seizures]] can develop.
 <imgcaption fig1|>{{ :cl:hyponatremia-approach.png?800|Approach to Hyponatremia, (from Papadakis M.A., McPhee S.J., Rabow M.W. Eds. Maxine A. Current Medical Diagnosis & Treatment 2017 New York, NY: McGraw-Hill)}}</imgcaption>