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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Aripiprazole stands out as the safer pick when it comes to low sodium risk. A large retrospective cohort study found that aripiprazole was associated with a 48% lower risk of hyponatremia compared to olanzapine among patients on second-generation antipsychotics. Risperidone, meanwhile, had the highest incidence rate of hyponatremia among the drugs studied.
When choosing between second-generation antipsychotics (SGAs), hyponatremia risk may be a more important consideration than previously recognized. A new retrospective cohort study published in JAMA Network Open found meaningful differences in hyponatremia risk across commonly used SGAs — with aripiprazole emerging as the lowest-risk option compared to olanzapine.
Researchers drew on FDA Adverse Event Reporting System data (1997–2023) and a Japanese hospital-based claims database (2008–2024), analyzing over 55,000 adults. Patients were monitored for up to 180 days after starting an antipsychotic, with hyponatremia defined as serum sodium < 135 mEq/L or related conditions.
By the Numbers:
Why it matters: For patients already at elevated risk for low sodium — such as older adults or those on diuretics — these findings could meaningfully guide antipsychotic selection, helping clinicians minimize a potentially serious and underappreciated side effect.
