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NEUROLOGY 1986;36:1506
© 1986 American Academy of Neurology

Perspective on carbamazepine-induced water intoxication

Reversal by demeclocycline Robert A. Ringel, MD and John F. Brick, MD

Department of Neurology, West Virginia University School of Medicine, Morgantown, WV.

Carbamazepine (CBZ)-induced water intoxication occasionally limits its usefulness in refractory seizures and trigeminal neuralgia. Fluid restriction, CBZ dose reduction, or concomitant phenytoin therapy may be impractical or ineffective. Demeclocycline (7-chloro-6 demethyl tetracycline) (DMC) corrected the CBZ-induced water intoxication in a 51-year-old man with refractory complex partial seizures and a normal antidiuretic hormone (ADH) level. DMC inhibits ADH-sensitive adenylate cyclase activity in the renal collecting duct and may be useful in correcting the ADH-like or renal antidiuretic effect of CBZ.

Address correspondence and reprint requests to Dr. Ringel, Department of Neurology, West Virginia University Medical Center, Morgantown, WV 26506.

Accepted for publication March 5, 1986.