Antidepressant induced recurrent hyponatremia: A case report

Area of Science:

• Pharmacology
• Clinical Medicine
• Neuroscience

Background:

• Hyponatremia is a recognized adverse effect of antidepressant medications.
• Selective serotonin reuptake inhibitors (SSRIs) are frequently associated with this electrolyte imbalance.

Observation:

• A case study involving a 57-year-old woman with HIV and HCV detailed four severe hyponatremia episodes within five months.
• The patient was treated with multiple medications including a thiazide diuretic, venlafaxine, citalopram, olanzapine, haloperidol, enalapril, and escitalopram.

Findings:

• Antidepressant-induced hyponatremia risk is elevated in elderly females, those on thiazide diuretics, with low-normal sodium levels, and low body weight.
• SSRIs are implicated, with hyponatremia typically appearing within the first month of treatment, independent of dosage.
• Recovery from hyponatremia is observed upon discontinuation of the offending antidepressant medication.

Implications:

• Early detection and risk factor assessment are vital for patients initiating antidepressant therapy.
• Periodic electrolyte monitoring and selection of safer psychopharmacologic alternatives are recommended.
• This highlights the importance of pharmacovigilance in managing antidepressant side effects.