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Association between antidepressant drug use and hyponatraemia: a case-control study
Kris L L Movig1, Hubert G M Leufkens, Albert W Lenderink
1Hospital Pharmacy Midden-Brabant, TweeSteden and St Elisabeth Hospital, Tilburg, The Netherlands. kmovig@zamb.tsz.nl
British Journal of Clinical Pharmacology
|April 23, 2002
Summary
Selective serotonin reuptake inhibitors (SSRIs) increase the risk of hyponatraemia compared to other antidepressants. Elderly patients using SSRIs with diuretics face the highest risk of this adverse drug reaction.
Area of Science:
- Clinical Pharmacology
- Psychiatry
- Internal Medicine
Background:
- Hyponatraemia, a common adverse drug reaction, is associated with antidepressant use.
- Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed antidepressants.
Purpose of the Study:
- To compare the risk of hyponatraemia in patients using SSRIs versus other antidepressant classes.
- To identify risk factors for SSRI-associated hyponatraemia.
Main Methods:
- A case-control study involving psychiatric patients in the Netherlands over two years.
- Cases (n=29) had serum sodium < or = 130 mmol/l; controls (n=78) had normal serum sodium.
- Unconditional multivariate logistic regression analyzed the association between SSRIs and hyponatraemia.
Main Results:
- SSRIs were associated with a significantly increased risk of hyponatraemia (OR 3.3; 95% CI 1.3, 8.6) compared to other antidepressants.
- Elderly patients (≥65 years) concurrently using diuretics and SSRIs exhibited the highest risk (OR 13.5; 95% CI 1.8, 101).
Conclusions:
- SSRIs are more frequently linked to hyponatraemia than other antidepressant drug classes.
- The risk of hyponatraemia is elevated in older patients and those using diuretics concurrently with SSRIs.