ArticleEpilepsia2025
Climate change and hyponatremia-related hospital admissions in people with focal epilepsy exposed to carbamazepine or its derivatives.
Article in Epilepsia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Induction of cytochrome P450 2C9 and P-glycoprotein activity by antiseizure medications: A systematic review and network meta-analysis.Epileptic disorders : international epilepsy journal with videotape · 2026Pooled it
- Climate Change: A National Survey on Viewpoints of Italian Epilepsy-Care Professionals.European journal of neurology · 2026Article
- Nabiximols improves sleep architecture in multiple sclerosis: A prospective polysomnographic study.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Article
- Climate change and hyponatremia-related hospital admissions in people with focal epilepsy exposed to carbamazepine or its derivatives.Epilepsia · 2025Article
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Authors and funding
11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate the proportion of individuals with focal epilepsy treated with at least one among carbamazepine (CBZ), oxcarbazepine (OXC), or eslicarbazepine (ESL), who were hospitalized due to hyponatremia-related symptoms in 2024, and to test the hypothesis that there is an association with climatic variables.
methodsWe undertook a prospective study in which people with focal epilepsy treated with at least one of the target drugs and at least one attendance in 2024 formed the study cohort. Individuals who were admitted or seen as outpatients for hyponatremia in 2024 were considered cases and the rest considered controls. Climate analysis was performed in Lamezia Terme, Calabria, Italy.
resultsSeventeen of the entire cohort of 105 (16.2%) had hyponatremia-related hospitalizations. Older age (odds ratio [OR] = 1.07, 95% confidence interval [CI] = 1.03-1.12; p = .001) and exposure to OXC/ESL compared to CBZ (OR = 4.15, 95% CI = 1.20-14.32; p = .02) emerged as significant predictors of the events. Thirteen of the 17 cases (76.5%) currently reside on the Calabria coastline. Twelve of 17 events (70.6%) occurred between June and August. Among climatic variables, heatwaves (OR = 4.87, 95% CI = 1.75-13.50; p = .002) and tropical nights (night-temperature ≥20°C) (OR = 2.72, 95% CI = 1.02-7.27; p = .046) were the most significant predictors of the events. Forecasting models based on 10 consecutive days of recordings prior to the events revealed trends of rising temperatures preceding the events. SIGNIFICANCE: We report a high rate of hyponatremia-related hospitalizations among people with epilepsy occurring predominantly during summer. Climate change-related events, such as heatwaves and tropical nights, may trigger hyponatremia symptoms. Climate-regional vulnerability should therefore also be considered when selecting antiseizure medications and when counseling patients. We encourage interdisciplinary collaboration between clinicians and climate scientists in this emerging critical area.
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