Varenicline
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First report of polydypsia and hyponatraemia: case report A 62-year-old man with schizophrenia developed polydypsia and hyponatraemia during treatment with varenicline for smoking cessation. The man started receiving varenicline, titrated to 1mg twice daily [route not stated], during a hospital stay for schizophrenia. His smoking habit improved with therapy, but paranoia, nihilism, delusions of reference, irritability and disorganisation developed. Nursing staff noticed polydypsia after 18 days of varenicline therapy. On day 20, his sodium level was 125 mmol/L (baseline 144 mmol/L), and urinalysis confirmed diluted urine. Varenicline was discontinued that day; attempts at restricting the man’s fluid intake were unsuccessful. He received a sodium chloride infusion on day 23, and his sodium levels and psychotic symptoms had resolved 2 days later. He was discharged after another 3 days, and polydypsia, hyponatraemia or psychotic symptoms did not recur during 5-weeks of follow-up; however, he did resume smoking. Author comment: "To our knowledge this is the first case report of poydipsia and hyponatremia associated with varenicline. We urge clinicians to be vigilant about the emergence of polydipsia when initiating varenicline treatment in smokers with schizophrenia." Ismail Z, et al. Varenicline induced polydipsia and hyponatremia in a patient with schizophrenia. Schizophrenia Research 119: 268, Jun 2010. Available from: URL: 803028043 http://dx.doi.org/10.1016/j.schres.2010.01.027 - Canada
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of polydypsia or hyponatraemia associated with varenicline. The WHO ADR database contained 13 reports of polydipsia and six reports of hyponatraemia associated with varenicline.
0114-9954/10/1311-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 24 Jul 2010 No. 1311
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