Severe hypokalemia probably associated with sertraline use

Area of Science:

• Cardiology
• Pharmacology
• Clinical Medicine

Background:

• Selective serotonin reuptake inhibitors (SSRIs) like sertraline are widely prescribed.
• Hypokalemia, a low potassium level, can lead to serious cardiac arrhythmias.
• The association between sertraline and hypokalemia is not well-established in medical literature.

Observation:

• A 48-year-old male presented with ventricular fibrillation and cardiac arrest post-coronary angiography.
• Immediate blood work revealed severe hypokalemia (2.44 mEq/L) with normal magnesium and ECG.
• Extensive investigation excluded other common causes of hypokalemia.

Findings:

• Sertraline 50 mg daily was identified as the probable cause of severe hypokalemia.
• The Naranjo adverse drug reaction scale indicated a probable relationship between sertraline and hypokalemia.
• This is the first documented case report of ventricular fibrillation linked to sertraline-induced hypokalemia.

Implications:

• Clinicians should consider sertraline as a potential cause of hypokalemia, especially in patients with cardiac events.
• Further research is needed to elucidate the pathogenic mechanism of sertraline's effect on potassium levels.
• Increased awareness may prevent similar adverse events in patients on sertraline therapy.