Low-Dose Lurasidone-Induced Polydipsia Complicated by Hyponatremia in a Patient With Bipolar Disorder. 2021

Sung-Tao Li, and Yi-Wei Yeh
Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

OBJECTIVE Atypical antipsychotic-induced hyponatremia has been reported in patients with psychiatric disorders. To date, hyponatremia due to lurasidone, an atypical antipsychotic approved for the treatment of schizophrenia and bipolar depression, has never been reported. METHODS A female patient with bipolar depression and a history of subdural hematoma experienced a rapid onset of hyponatremia after the initiation of low-dose lurasidone. The hyponatremia worsened after the dose of lurasidone was increased and resolved only after lurasidone was ceased. According to the Naranjo Adverse Drug Reaction Probability Scale, this case report scores 6 as a possible drug reaction between lurasidone and hyponatremia. RESULTS Based on laboratory results, the syndrome of inappropriate antidiuretic hormone secretion and thyroid or adrenal dysfunction as differential diagnoses were excluded. Lurasidone-induced polydipsia complicated by hyponatremia was confirmed. Lurasidone was subsequently discontinued. The sodium level returned to normal within 1 week without any sodium supplementation. CONCLUSIONS This case report highlighted that low-dose lurasidone may induce polydipsia complicated by hyponatremia. Physicians should be aware of the adverse reactions of hyponatremia associated with lurasidone, particularly in patients with a history of intracranial hemorrhage.

UI MeSH Term Description Entries
D007010 Hyponatremia Deficiency of sodium in the blood; salt depletion. (Dorland, 27th ed) Hyponatremias
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069056 Lurasidone Hydrochloride A thiazole derivative and atypical ANTIPSYCHOTIC AGENT that functions as a DOPAMINE D2 RECEPTOR ANTAGONIST; SEROTONIN 5-HT2 RECEPTOR ANTAGONIST, serotonin 5-HT7 receptor antagonist, and antagonist of the adrenergic α2A and α2C receptors, as well as a partial SEROTONIN 5-HT1A RECEPTOR AGONIST. It is used in the treatment of SCHIZOPHRENIA and BIPOLAR DISORDER. Latuda,Lurasidone,Lurasidone HCl,N-(2-(4-(1,2-benzisothiazol-3-yl)-1-piperazinylmethyl)-1-cyclohexylmethyl)-2,3-bicyclo(2.2.1)heptanedicarboximide,SM 13496,SM-13,496,SM-13496,SM13496,13496, SM,HCl, Lurasidone,Hydrochloride, Lurasidone,SM 13,496,SM13,496
D001714 Bipolar Disorder A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. Affective Psychosis, Bipolar,Bipolar Disorder Type 1,Bipolar Disorder Type 2,Bipolar Mood Disorder,Depression, Bipolar,Manic Depression,Manic Disorder,Manic-Depressive Psychosis,Psychosis, Manic-Depressive,Type 1 Bipolar Disorder,Type 2 Bipolar Disorder,Psychoses, Manic-Depressive,Bipolar Affective Psychosis,Bipolar Depression,Bipolar Disorders,Bipolar Mood Disorders,Depression, Manic,Depressions, Manic,Disorder, Bipolar,Disorder, Bipolar Mood,Disorder, Manic,Manic Depressive Psychosis,Manic Disorders,Mood Disorder, Bipolar,Psychoses, Bipolar Affective,Psychoses, Manic Depressive,Psychosis, Bipolar Affective,Psychosis, Manic Depressive
D014150 Antipsychotic Agents Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in SCHIZOPHRENIA; senile dementia; transient psychosis following surgery; or MYOCARDIAL INFARCTION; etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus. Antipsychotic,Antipsychotic Agent,Antipsychotic Drug,Antipsychotic Medication,Major Tranquilizer,Neuroleptic,Neuroleptic Agent,Neuroleptic Drug,Neuroleptics,Tranquilizing Agents, Major,Antipsychotic Drugs,Antipsychotic Effect,Antipsychotic Effects,Antipsychotics,Major Tranquilizers,Neuroleptic Agents,Neuroleptic Drugs,Tranquillizing Agents, Major,Agent, Antipsychotic,Agent, Neuroleptic,Drug, Antipsychotic,Drug, Neuroleptic,Effect, Antipsychotic,Major Tranquilizing Agents,Major Tranquillizing Agents,Medication, Antipsychotic,Tranquilizer, Major
D059606 Polydipsia Excessive thirst manifested by excessive fluid intake. It is characteristic of many diseases such as DIABETES MELLITUS; DIABETES INSIPIDUS; and NEPHROGENIC DIABETES INSIPIDUS. The condition may be psychogenic in origin. Polydipsias

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