Antidepressant-Induced Hyponatremia

Cury, Letícia H.; Kitadai, Fábio Takashi; Helou, Claudia M. B.

doi:10.1590/s1807-59322006000600015

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…One of the possible mechanisms is the serotonin stimulatory effect of antidiuretic hormone secreted from the posterior pituitary gland, which is mediated by the 5HT2 and 5HT1 receptors (31). This syndrome consists of faulty urine dilution in the presence of plasma hyposmolality (32).…”

Section: Antidepressant Drug-induced Hyponatremiamentioning

confidence: 99%

Sodium and Depression: Hypothetical Associations

Özdemir¹

2013

Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychophar

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Section: Antidepressant Drug-induced Hyponatremiamentioning

confidence: 99%

Sodium and Depression: Hypothetical Associations

Özdemir¹

2013

Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychophar

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“…A hiponatremia secundária a ISRS tende a aparecer entre 2 e 120 dias após o início do tratamento, em média no 13º dia de tratamento, podendo mesmo surgir até 16 meses após, não sendo o efeito dose-dependente, e a normalização ocorre entre 2 e 28 dias após a suspensão do fármaco 13,16,18,22,29,31 . No entanto, ainda que não pareça existir um efeito dose-dependente, há alguns relatos de hiponatremia após o aumento de dose do fármaco 27 .…”

Section: Inibidores Seletivos Da Recaptação De Serotoninaunclassified

Hiponatremia associada a antidepressivos: uma revisão

Costa¹,

Marins²

2018

J. bras. psiquiatr.

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RESUMOObjetivo: Rever a literatura mais recente sobre a associação entre a hiponatremia e o uso de antidepressivos. Métodos: Pesquisa bibliográfica nas bases de dados PubMed e SciELO, com os descritores "antidepressive agents" e "hyponatremia", incluindo artigos de janeiro de 2006 a maio de 2016. Resultados: Foram incluídos 45 artigos. A idade, o sexo feminino e a polimedicação são os fatores de risco mais relevantes, e os sintomas dependem da gravidade da hiponatremia. A hiponatremia pode ter várias causas, sendo a mais comum a síndrome da secreção inapropriada do hormônio antidiurético. Entre os inibidores seletivos da recaptação de serotonina, o citalopram e o escitalopram apresentam risco superior, à semelhança da venlafaxina. O risco de hiponatremia parece ser inferior com as classes restantes, à exceção dos inibidores da monoaminoxidase. Recomenda-se um ionograma prévio ao tratamento em doentes com mais de 60 anos e, sempre, um ionograma um mês após o seu início. O primeiro passo do tratamento é a suspensão do fármaco, revertendo a maioria dos casos leves. No entanto, o tratamento deve ser individualizado, considerando os riscos da hiponatremia e da correção. Conclusões: A hiponatremia é um efeito colateral a considerar nos doentes que tomam antidepressivos. Quando a manutenção do tratamento é necessária, deve ser evitado o mesmo antidepressivo ou outro da mesma classe, sendo opções a trazodona, abupropiona, a agomelatina, a mirtazapina e a reboxetina, porque existem poucos relatos de hiponatremia com esses fármacos. ABSTRACTObjective: Review the most recent literature about the association between hyponatremia and antidepressives' intake. Methods: Bibliographic search in PubMed and SciELO databases, with the MeSH terms "antidepressive agents" and "hyponatremia", including articles between January 2006 and May 2016. Results: A total of 45 articles have been included. Age, female sex and polymedication are the main risk factors and symptoms depend on hyponatremia severity. Hyponatremia may have several causes, being the most common the syndrome of inappropriate antidiuretic hormone secretion. Between the selective serotonin reuptake inhibitors, citalopram and escitalopram presented a bigger risk, similarly to venlafaxine. Risk of hyponatremia seems smaller with the other antidepressives' classes, with exception to

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“…The causes of this syndrome are usually divided into four main categories, which include neoplasms, central nervous system disorders, lung diseases and medications. The main symptoms are usually non-specific and range from mild lethargy, anorexia, insomnia, fatigue, nausea, muscle cramps, headache and confusion, even leading upto coma [9]. The previous drug utilization studies have found depressive disorders as being one of the most commonly encountered clinical conditions in a psychiatric setting [10].…”

Section: Introductionmentioning

confidence: 99%

Hyponatremia Secondary to Antidepressant Therapy - A Post Marketing Safety Study

Shetty¹

2015

J Pharmacovigil

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Background: Most antidepressants have been associated with hyponatremia. The risk is highest during the early stages of the treatment. Symptoms are commonly mistaken for physical complaints of old age or the underlying conditions. Speed of onset determines the risk of developing symptoms. Aims and Objectives:To establish the incidence, risk factors, time course of detection of hyponatremia complicating treatment with antidepressant therapy. Also, to objectively assess the causality, severity and preventability of hyponatremia as an adverse drug reaction. Methods:The study was carried out in collaboration between the Departments of Pharmacology and Psychiatry, Mahatma Gandhi Medical College and Research Institute, India. The source populations in our study were all the out-and in-patients on antidepressant therapy with normal serum sodium concentration meeting the eligibility criteria of the study. The assessment of causality, severity and preventability of the hyponatremia with the use of anti-depressant therapy were assessed using Naranjo's scale, Hartwig and Siegel's scale, and Schumock and Thornton's scale respectively.Results: A total of 24 cases had hyponatremia with 21 cases assessed as "probable" on Naranjo's Scale. We found a moderately strong positive correlation between the use of mirtazapine and occurrence of hyponatremia with a p value of 0.089. The use of venlafaxine also suggested a positive correlation with a p value of 0.097. Though not statistically significant we found cases reported for Milnacipran. Mean ± SD for overall time to detection of hyponatremia was 224.71 ± 117.79 days. In the univariate regression, we found SNRIs and Mirtazapine to have significant association with hyponatremia. However, none of the other factors and concomitant medications proved to have a significant association on multivariate regression analysis. Conclusion:Hyponatremia is an under recognized and potentially serious complication of antidepressant therapy. Our results provide a foundation for understanding the safety profile of antidepressants in a clinical setting of hyponatremia and its impact on suitable monitoring and treatment strategy. Journal of PharmacovigilanceJou rn a l o f P harma c o v ig il a nc e

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Antidepressant-Induced Hyponatremia

Cited by 4 publications

References 10 publications

Sodium and Depression: Hypothetical Associations

Sodium and Depression: Hypothetical Associations

Hiponatremia associada a antidepressivos: uma revisão

Hyponatremia Secondary to Antidepressant Therapy - A Post Marketing Safety Study

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