New-onset seizures with cerebral edema as a direct effect of antipsychotic medications

Abstract

Patients developing hyponatremia while on antipsychotic medications may have widely varied clinical presentations, ranging from being asymptomatic to developing altered sensorium, cerebral edema, or even death. In these patients, hyponatremia may develop secondary to over-dosage of medications, psychogenic polydipsia or due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). There have been reports of hyponatremia occurring as a direct adverse effect of antipsychotic medications although not severe enough to cause cerebral edema and seizures. Unusual neurological symptoms presenting in patients on antipsychotic medications are often mistaken for the psychiatric illness itself and a diagnosis of hyponatremia can be overlooked, resulting in delayed treatment. We would like to report one such case of severe symptomatic hyponatremia in a patient on antipsychotic medications.