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      A Case Report of Syndrome of Inappropriate Antidiuretic Hormone Induced by Pregabalin

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          Abstract

          The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hyponatremia, and many medications have been associated with SIADH. Pregabalin is a drug used for the treatment of neuropathic pain, though common adverse effects include central nervous system disturbance, peripheral edema, and weight gain. However, hyponatremia caused by pregabalin has been rarely reported. Here we report a patient with pregabalin-induced hyponatremia who met the criteria for SIADH; after discontinuation of the drug, his condition rapidly improved. This case can help clinicians diagnose and treat new-onset hyponatremia in patients who recently initiated pregabalin therapy.

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          The mechanisms of action of gabapentin and pregabalin.

          Graeme J. Sills (2006)
          Gabapentin and pregabalin are structurally related compounds with recognized efficacy in the treatment of both epilepsy and neuropathic pain. The pharmacological mechanisms by which these agents exert their clinical effects have, until recently, remained unclear. The interaction of gabapentin and pregabalin with conventional antiepileptic and analgesic drug targets is likely to be modest, at best, and has been largely dismissed in favour of a selective inhibitory effect on voltage-gated calcium channels containing the alpha2delta-1 subunit. This mechanism is consistently observed in both rodent- and human-based experimental paradigms and may be sufficiently robust to account for much of the clinical activity of these compounds.
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            The syndrome of inappropriate secretion of antidiuretic hormone.

            Frederic C. Bartter, William Schwartz (1967)
            Article 0 comments Cited 110 times – based on 0 reviews     Review now
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              Causes and management of hyponatremia.

              M Lader, Raymond F. Palmer, R. Gates (2003)
              To review clinical information on the incidence and causes of hyponatremia (defined as a serum sodium level <130 mEq/L), the most common electrolyte abnormality seen in general hospital patients, and to discuss the diagnosis and treatment of hyponatremia in relation to these factors. Primary sources and review articles were identified via MEDLINE (1981-July 2003) for entries on hyponatremia. We limited the search to specific topics including incidence, risk factors, diagnosis, treatment, and clinical disorders and medications associated with hypotonic hyponatremia. All of the articles identified were evaluated, and relevant and representative information was included in this review. Hyponatremia can result from several disease states, injury, surgery, physical exercise, or the administration of certain drugs (e.g., antidepressants, antiepileptics) and is associated with advanced age. Drug-induced hyponatremia is often asymptomatic and usually resolves following water restriction and monitoring of medication. Symptoms of hyponatremia are primarily neurologic; the principal danger of hyponatremia relates to effects on central nervous system function due to changes in brain size. Although hyponatremia can be a serious condition, appropriate measures for the management of at-risk and affected patients will lead to full recovery in most cases.
              Article 0 comments Cited 24 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Electrolyte Blood Press
                Journal ID (iso-abbrev): Electrolyte Blood Press
                Journal ID (publisher-id): EBP
                Title: Electrolytes & Blood Pressure : E & BP
                Publisher: The Korean Society of Electrolyte Metabolism
                ISSN (Print): 1738-5997
                ISSN (Electronic): 2092-9935
                Publication date (Print): December 2016
                Publication date (Electronic): 31 December 2016
                Volume: 14
                Issue: 2
                Pages: 31-34
                Affiliations
                Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
                Author notes
                Corresponding Author: Beom Kim, M.D., Ph.D., Department of Internal Medicine, Veterans Health Service Medical Center, 61 Gil 53, Jinhwang-ro, Gangdong-gu, Seoul 05368, Korea. Tel: +82-2-2225-1111, Fax: +82-2-2225-4348, glom@ 123456hanafos.com
                Article
                DOI: 10.5049/EBP.2016.14.2.31
                PMC ID: 5337431
                PubMed ID: 28275386
                SO-VID: 1350aee8-d81e-4623-9d16-4601186a3a8c
                Copyright © Copyright © 2016 The Korean Society of Electrolyte Metabolism
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 November 2016
                Date accepted : 23 January 2017
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: drug associated syndrome of inappropriate antidiuretic hormone secretion,hyponatremia,pregabalin
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: drug associated syndrome of inappropriate antidiuretic hormone secretion, hyponatremia, pregabalin

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