Was hoping to pick the brains of my fellow psychiatrists. I have a patient who has been on tegretol for 3 months and her sodium dropped from 138 before treatment to 132 over the past 3 checks (every 3 weeks). She had problems with lithium and depakote so non-options. She is on an atypical but historically it does not seem to hold her alone. She is relatively new to me. She is doing great in terms of symptom control with the tegretol but its purely the salt.
She is a more moderate functioning person cognitively so having her do a complicated water restriction is not going to work. The last thought before bailing on it if sodium dips any lower is to do a daily salt tab. In most I would just have them salt food but again she has an RN come to give her meds twice a day and is not reliable enough to do it on her own so the RN could give the tab.
I am ok starting democycline too but would rather not complicae things. Anyone done well with simply adding some salt into the diet?
She is a more moderate functioning person cognitively so having her do a complicated water restriction is not going to work. The last thought before bailing on it if sodium dips any lower is to do a daily salt tab. In most I would just have them salt food but again she has an RN come to give her meds twice a day and is not reliable enough to do it on her own so the RN could give the tab.
I am ok starting democycline too but would rather not complicae things. Anyone done well with simply adding some salt into the diet?