Syndrome of inappropriate secretion of antidiuretic hormone due to citalopram and venlafaxine

Romero, Soledad; Pintor, Luís; Serra, Montserrat; Plana, Teresa; Navarro, Vı́ctor; Gastó, Cristòbal; Goldstein, Benjamin I.

doi:10.1016/j.genhosppsych.2006.11.001

Cited by 21 publications

(7 citation statements)

References 14 publications

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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

“…Por inibirem a recaptação tanto de serotonina como de noradrenalina, essa hiponatremia tende a aparecer mais precocemente do que com os ISRS 36 . Foram encontrados relatos de casos de hiponatremia associada a vários ISRSN: duloxetina 36,37 , desvenlafaxina 38,39 e venlafaxina 16,18,40 . Um estudo retrospectivo encontrou incidência de hiponatremia de 4,2% na quarta semana de tratamento com venlafaxina 11 , enquanto um estudo prospetivo conseguiu encontrar incidência de 17,2% em doentes com idade superior a 65 anos, sendo todos os casos detectados em cinco dias após o início do tratamento com venlafaxina 41 .…”

Section: Inibidores Seletivos De Recaptação De Serotonina E Noradrenaunclassified

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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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Section: Inibidores Seletivos Da Recaptação De Serotoninaunclassified

Section: Inibidores Seletivos De Recaptação De Serotonina E Noradrenaunclassified

Hiponatremia associada a antidepressivos: uma revisão

Costa¹,

Marins²

2018

J. bras. psiquiatr.

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“…[63] SIADH has been associated with several psychotropic drugs, notably serotonin reuptake inhibitors (SRIs), the anticonvulsants carbamazepine and oxcarbazepine and, less often, tricyclic antidepressants (TCAs) or other types of antidepressants, opioids and perhaps nicotine and the psychoactive agent 3,4-methylenedioxy-N-methylamphetamine (MDMA; 'ecstasy'). [64][65][66][67][68][69][70][71][72] Although antipsychotics rarely cause SIADH, coadministration of multiple antipsychotics can lead to hyponatraemia. [73][74][75] SIADH can also complicate the use of synthetic ADH-like agents including desmopressin (especially with rapidly absorbed nasal sprays), sometimes used to treat enuresis, including polyuria associated with psychotropics such as lithium and clozapine.…”

Section: Hyponatraemia and Syndrome Of Inappropriate Antidiuretic Hormentioning

confidence: 99%

Adverse Endocrine and Metabolic Effects of Psychotropic Drugs

et al. 2009

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The article critically reviews selected, clinically significant, adverse endocrine and metabolic effects associated with psychotropic drug treatments, including hyperprolactinaemia, hyponatraemia, diabetes insipidus, hypothyroidism, hyperparathyroidism, sexual dysfunction and virilization, weight loss, weight gain and metabolic syndrome (type 2 diabetes mellitus, dyslipidaemia and hypertension). Such effects are prevalent and complex, but can be managed clinically when recognized. They encourage continued critical assessment of benefits versus risks of psychotropic drugs and underscore the importance of close coordination of psychiatric and general medical care to improve long-term health of psychiatric patients. Options for management of hyperprolactinaemia include lowering doses, switching to agents such as aripiprazole, clozapine or quetiapine, managing associated osteoporosis, carefully considering the use of dopamine receptor agonists and ruling out stress, oral contraceptive use and hypothyroidism as contributing factors. Disorders of water homeostasis may include syndrome of inappropriate antidiuretic hormone (SIADH), managed by water restriction or slow replacement by hypertonic saline along with drug discontinuation. Safe management of diabetes insipidus, commonly associated with lithium, involves switching mood stabilizer and consideration of potassium-sparing diuretics. Clinical hypothyroidism may be a more useful marker than absolute cut-offs of hormone values, and may be associated with quetiapine, antidepressant and lithium use, and managed by thyroxine replacement. Hyper-parathyroidism requires comprehensive medical evaluation for occult tumours. Hypocalcaemia, along with multiple other psychiatric and medical causes, may result in decreased bone density and require evaluation and management. Strategies for reducing sexual dysfunction with psychotropics remain largely unsatisfactory. Finally, management strategies for obesity and metabolic syndrome are reviewed in light of the recent expert guidelines, including risk assessment and treatments, such as monoamine transport inhibitors, anticonvulsants and cannabinoid receptor antagonists, as well as lifestyle changes.

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“…The condition develops within the first few weeks of treatment and resolves within 2 weeks of therapy discontinuation. SSRI-induced hyponatremia is probably secondary to development of a syndrome of inappropriate secretion of antidiuretic hormone (Romero, et al, 2007;Rottmann, 2007). Risk factors for developing SSRI-induced hyponatremia are advanced age, female gender and the concomitant use of diuretics.…”

Section: Hyponatremiamentioning

confidence: 99%

Review: Problems associated with long-term treatment with selective serotonin reuptake inhibitors

Moret¹,

Isaac

Briley³

2008

J Psychopharmacol

120

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Although the selective serotonin reuptake inhibitors (SSRIs), which are now widely used as a first-line treatment for depression and many other psychiatric conditions, are generally well tolerated, they are not devoid of side effects. Most short-term treatment-related side effects of SSRIs are transient and disappear after a few days or weeks. However, following long-term treatment with the SSRIs, some serious adverse events may occur. Some of them can be difficult to recognise because they can resemble residual symptoms of depression. The most serious can be life threatening. They all have a negative influence on the patient's quality of life and are frequently a prime reason for a lack of long-term compliance with the associated increased risk of recurrence of a depressive episode. This article is an overview of the more common adverse events, which are seen with non-acute treatment with the SSRIs.

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Syndrome of inappropriate secretion of antidiuretic hormone due to citalopram and venlafaxine

Cited by 21 publications

References 14 publications

Hiponatremia associada a antidepressivos: uma revisão

Hiponatremia associada a antidepressivos: uma revisão

Adverse Endocrine and Metabolic Effects of Psychotropic Drugs

Review: Problems associated with long-term treatment with selective serotonin reuptake inhibitors

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