Hyponatremia in an Older Patient

Paroxetine-Induced Hyponatremia in Older Adults

“…Since the introduction of SSRIs more than a decade ago, the medical literature is replete with isolated case reports of clinically significant hyponatremia in aged patients treated with these agents. [6][7][8] In a case note review, Strachan and Shepherd 9 reported hyponatremia in 5 (28%) of 18 elderly patients prescribed fluoxetine hydrochloride and 8 (22%) of 37 prescribed paroxetine, although an earlier retrospective case-control study of 845 patients documented that hyponatremia developed in 1 of 200 patients treated per year with these agents. 10 More recently, Kirby et al 11 recently reported a 39% incidence of hyponatremia in a retrospective analysis of 74 elderly inpatients who were receiving treatment with an SSRI or with venlafaxine hydrochloride.…”

Grand rounds: Acute changes in mental status secondary to selective serotonin reuptake inhibitor-induced hyponatremia.

“…SIADH may result secondary to malignant neoplasms, nonmalignant pulmonary disease, and various disorders of the central nervous system (Liu, Mittmann, Knowles, & Shear, 1996). Multiple case studies and small sample investigations (e.g., Christe & Vogt, 1999; John, Perreault, Tao, & Blew, 1997; Kelly, Robinson, & Beringer, 1999; Levsky & Schwartz, 1998; Spigset & Mjorndal, 1997; Spigset, Wilhelmsson, Mjorndal, & Eriksson, 2000) have identified the onset of hyponatremia secondary to SIADH in association with SSRI therapy. Most of these reports have involved geriatric patients.…”