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Delayed recurrent SIADH associated with SSRIs
Zeev H Arinzon1, Yehoshua A Lehman, Zeev G Fidelman
1Department of Internal Medicine, Frieda Schiff Warburg Geriatric Medical Center, Ministry of Health, Dora, Netanya, Israel. Darinzon@newmail.net
The Annals of Pharmacotherapy
|June 28, 2002
Summary
Elderly patients switching antidepressants may experience delayed hyponatremia (low sodium). Continuous monitoring of plasma sodium levels is crucial throughout selective serotonin-reuptake inhibitor (SSRI) treatment.
Area of Science:
- Geriatric Medicine
- Clinical Pharmacology
- Psychiatry
Background:
- Depression is prevalent in the elderly, often managed with SSRIs.
- SSRIs are a common treatment for depression in older adults.
Observation:
- A case of delayed recurrent hyponatremia occurred in an 87-year-old woman after switching SSRIs.
- Hyponatremia developed 16 months after initiating paroxetine, a different SSRI.
Findings:
- The patient experienced recurrent hyponatremia, likely related to paroxetine.
- Discontinuation of paroxetine led to normalization of serum sodium levels.
Implications:
- Switching SSRIs in elderly patients can lead to delayed, recurrent hyponatremia.
- Plasma sodium monitoring is essential throughout the entire course of SSRI therapy, not just initially.
- This case highlights the importance of vigilant monitoring for adverse drug reactions in geriatric populations.