REVIEW Psychiatry and Behavioral Sciences 2018;8(4):213-21 https://doi.org/10.5455/PBS.20180324094723 213 INTRODUCTION Sodium is an electrolyte, and it helps to regulate the amount of water that's in and around the cells. It is a most common electrolyte abnormality seen in psychiatric as well as other clinical practices and is associated with multiple poor clinical after effects including falls, fractures, long hospital stay and mortality. Hyponatremia, is defined as the serum sodium level below 135 mmol/L (1, 2). The condition is rarely symptomatic until serum sodium level falls below 120 mmol/1 and become symptomatic if it is 110 mmol/L. It is especially seen in patients with alcohol use disorder and it has the mortality rate over 50 percent. Among beer drinkers and malnourished patients always have reduced ability to excrete free water based on low intake and such patients develop hyponatremia with low urine osmolality. The primary symptoms of hyponatremia are restlessness, drowsiness, myoclonic jerks, and generalized convulsions followed by confusion, coma and death if not treated properly. It occurs in the hospitalized patients as well as in routine (outpatient) psychiatric clinical practice (3). It also exacerbates psychotic symptoms. Some studies said that hyponatremia evolve in a general hospital population as it occurs in about 1 percent of patients (4). In psychiatric patients the frequency of hyponatremia has been reported to range from 3.3 percent to 12.2 percent (5). It commonly occurs in old age patients, those who are hospitalized or living in long-term care facilities because of the higher rate of comorbid conditions such as cardiac, hepatic, or renal failure which could lead to hyponatremia. Even though it is estimated that nearly 7% of healthy elderly persons have serum sodium concentrations of 137 mEq/L or less (6). However, in some studies it was reported that hyponatremia may have been present in 15 to 18 percent of patients in chronic care facilities (7). Hyponatremia resulting from inappropriate secretion of antidiuretic hormone and renal sodium loss referred SIADH (syndrome of inappropriate secretion of Psychotropic-Induced Hyponatremia: A Review ABSTRACT Psychotropic-induced hyponatremia is the most common electrolyte imbalance experienced in the psychiatric clinical practice. It is commonly seen in geriatric patients and it is always overlooked and untreated in psychiatric patients and this would explain why it leads to increased mortality. Psychotropic drugs such as antidepressants, antipsychotics, mood stabilizers, and sedative- hypnotics can lead to hyponatremia, while it commonly occurs in antidepressant use. In this review, a thorough search was performed using the databases of ResearchGate, PubMed, Scopus, PsycInfo, ScienceDirect, and Google Scholar. This review aimed to shed light on the probable psychopathology, evaluation of hyponatremia, a closer look at different types of hyponatremia, and its incidence with various psychotropic medications. We also summarized the clinical presentations of hyponatremia, the identified risk factors with various psychotropic, and concluded by discussing the mainstay management of hyponatremia. Keywords: Antipsychotics, hyponatremia, selective serotonin reuptake inhibitors, syndrome of inappropriate secretion of antidiuretic hormone (SIADH) Corresponding author: Javed Ather Siddiqui Department of Psychiatry, Mental Health Hospital, Taif, Saudi Arabia and Seth GS Medical College and KEM Hospital, Mumbai, India E-mail: javedsiddiqui2000@gmail.com Received: May 24, 2018 Accepted: August 08, 2018 Citation: Ather Siddiqui J, Qureshi SF, Al Zaharani A. Psychotropic-Induced Hyponatremia: A Review. Psychiatry and Behavioral Sciences 2018;8(4):213-21. https://doi.org/10.5455/PBS.20180324094723 Javed Ather Siddiqui 1 , Shazia Farheen Qureshi 2 , Abdullah Al Zaharani 3 1 Department of Psychiatry, Mental Health Hospital, Taif, Saudi Arabia and Seth GS Medical College and KEM Hospital, Mumbai, India 2 Department of Psychiatry, Mental Health Hospital, Taif, Saudi Arabia and Government Medical College, Aurangaba, India 3 Department of Psychiatry, Mental Health Hospital, Taif, Saudi Arabia