Rapid-onset hyponatremia and delirium following duloxetine treatment for postherpetic neuralgia

Wang, Dandan; Lai, Jianbo; Lu, Shao Wei; Huang, Manli; Hu, Shaohua; Xu, Yi

doi:10.1097/md.0000000000013178

Cited by 14 publications

(15 citation statements)

References 23 publications

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“…Diabetes is a common disease in elderly patients. [ 28 ] The results of this study suggest that the awareness and importance of diabetes should be improved, and the impact of poor blood glucose control on postoperative complications should be fully considered during the perioperative period. [ 29 ] Strict monitoring and control of blood glucose are needed for postoperative patients.…”

Section: Discussionmentioning

confidence: 99%

The risk factors of postoperative delirium in general anesthesia patients with hip fracture

Chu

Yi-xuan²,

Dai³

et al. 2021

Medicine

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Delirium is a common postoperative complication of patients with hip fracture, yet the risk factors for postoperative delirium in patients with hip fracture remain unclear. We aimed to evaluate the associated risk factors of postoperative delirium in patients with hip fracture, to provide evidence for formulating coping measures of postoperative delirium prevention and treatment in clinical practice. Patients undergoing surgery for hip fracture from March 1, 2018 to September 30, 2020 in our hospital were included. The related characteristics and related lab examination results were reviewed and collected. The univariate and logistic regression analyses were performed to identify the potential risk factors. A total of 462 patients were included, the incidence of postoperative delirium in patients with hip fracture was 16.02%. Logistic regression analyses indicated that history of delirium (OR = 4.38, 1.15–9.53), diabetes mellitus (OR = 5.31, 1.23–10.75), hypoalbuminemia (OR = 4.97, 1.37–9.86), postoperative hypoxemia (OR = 5.67, 2.24–13.42), and body mass index (BMI) (kg/m 2 ) (OR = 3.03, 1.36–6.18) were the independent risk factors for the delirium in patients with hip fracture surgery (all P < 0.05). The cutoff value of postoperative blood sugar, albumin, and BMI for delirium prediction was 8.05 (mmol/L), 32.26 (g/L), and 19.35 (kg/m 2 ), respectively, and the area under curve of postoperative blood sugar, albumin, and BMI was 0.792, 0.714, and 0.703, respectively. Those patients with a history of delirium, postoperative hypoxemia, blood glucose ≥8.05 mmol/L, albumin ≤32.26 g/L, and BMI ≤19.35 kg/m 2 particularly need the attention of healthcare providers for the prevention of delirium.

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Section: Discussionmentioning

confidence: 99%

The risk factors of postoperative delirium in general anesthesia patients with hip fracture

Chu

Yi-xuan²,

Dai³

et al. 2021

Medicine

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“…There are multiple reports of patients developing hyponatremia upon initiation or while taking chronic duloxetine [7][8][9][10][11][12][13][14][15][16][17][18]. We present a case of acute severe hyponatremia due to an overdose of duloxetine, which has not been previously described.…”

Section: Introductionmentioning

confidence: 82%

“…Our patient reached a nadir of 118 mmol/L on day 4 of hospitalization; however, administration of additional duloxetine doses on days 3 and 4 of hospitalization and the large overdose of duloxetine (450 mg) prior to admission may have prolonged stabilization to seven days. Previous reports have documented hyponatremia within two to five days after initiating duloxetine or after a dose escalation on chronic duloxetine therapy, but have not demonstrated a case this severe and abrupt in the setting of an overdose [7,[9][10][11][12][13][14][15][16][17][18]. Amoako et al described a 76-year-old female treated with duloxetine for fibromyalgia.…”

Section: Discussionmentioning

confidence: 99%

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Acute Severe Hyponatremia Induced by a Duloxetine Overdose in an Elderly Woman

Oliver

D’Angelo

Gonzales

et al. 2020

Cureus

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We report a case of acute severe hyponatremia within 24 hours after a duloxetine overdose. An 82-year-old woman presented to the ED after ingesting duloxetine and diltiazem. She became hemodynamically unstable due to the diltiazem overdose and was appropriately resuscitated. During hospitalization she experienced hyponatremia consistent with syndrome of inappropriate antidiuretic hormone (SIADH). Based on the observations we concluded there was a probable relationship between the hyponatremia and the duloxetine overdose. Clinicians should monitor patients' electrolytes for acute disturbances after an overdose of duloxetine.

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“…No severe drug-related side effects or AEs were observed. Notably, duloxetine was found with rapid-onset hyponatremia and delirium, according to a recent investigation [ 33 ]. Concerning events will be carefully monitored throughout the study period.…”

Section: Discussionmentioning

confidence: 99%

Effect of duloxetine premedication for postherpetic neuralgia within 72 h of herpes zoster reactivation [PROCESS]: a study protocol for a randomized controlled trial

Chen

Shrestha

Zhao

et al. 2020

Trials

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Background Postherpetic neuralgia (PHN) is the most common complication attributed to herpes zoster, which involves the reactivation of residual varicella zoster virus. It has been reported previously that pre-emptive amitriptyline following acute herpes zoster has shown latent positive effects in the prevention of PHN. In this study, by interfering with the same targets, norepinephrine and serotonin, we aim to evaluate whether pre-emptive duloxetine may proactively prevent PHN development. Methods This is a nationwide multicentric, randomized, open-label, blinded-endpoint study that will recruit 750 participants from 18 primary centres in China. Patients aged more than 50 years who are diagnosed with uncomplicated HZ, present with vesicles within 72 h of their emergence, and have an average pain score of at least 40/100 mm on a visual analogue scale (VAS, 0 mm = no pain, 100 mm = worst possible pain, at opposite ends of a 100-mm line) will be recruited for this study. Participants will be randomized into a duloxetine arm and a control arm. Participants allocated to the duloxetine arm will be given antivirals, analgesics and duloxetine, while those allocated to the control arm will receive antivirals and analgesics but no duloxetine. The primary outcome of this study is preventive efficacy against PHN, which will be evaluated based on a 100 mm VAS. Any pain scores other than 0 mm on the VAS 12 weeks after HZ onset will be defined as PHN. The secondary outcomes will consist of the average weekly VAS score, the average weekly consumption of each analgesic, weekly feature of the pain, patients’ quality of life based on the 12-item Short-Form Health Survey, Patient Global Impression of Change Scale, sleep quality as evaluated by the Pittsburgh Sleep Quality Index and adverse events during the study period. Discussion This study will investigate a prophylactic approach for reducing the prevalence of postherpetic neuralgia with duloxetine and will add significant new knowledge on the preventive effects of duloxetine on PHN. Trial registration Clinicaltrials.gov NCT04313335. Registered on 18 March 2020.

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Rapid-onset hyponatremia and delirium following duloxetine treatment for postherpetic neuralgia

Cited by 14 publications

References 23 publications

The risk factors of postoperative delirium in general anesthesia patients with hip fracture

The risk factors of postoperative delirium in general anesthesia patients with hip fracture

Acute Severe Hyponatremia Induced by a Duloxetine Overdose in an Elderly Woman

Effect of duloxetine premedication for postherpetic neuralgia within 72 h of herpes zoster reactivation [PROCESS]: a study protocol for a randomized controlled trial

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