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Zolpidem induced hyponatremia: a case report
Shanmuga Priya S1, Britto Dl2, Saravanan T3
1Assistant Professor, Department of Pharmacology, PSG Institute of Medical Sciences & Research , Off Avinashi Road, Peelamedu, Coimbatore, Tamilnadu, India .
Journal of Clinical and Diagnostic Research : JCDR
|November 12, 2014
Summary
This case report details a patient experiencing hyponatremia, a potentially dangerous electrolyte imbalance, linked to high-dose zolpidem use. The findings suggest zolpidem may induce SIADH, necessitating careful monitoring in patients with chronic insomnia.
Area of Science:
- Pharmacology
- Endocrinology
- Neurology
Background:
- Zolpidem, a non-benzodiazepine hypnotic, targets GABAA receptors.
- Patient history includes chronic insomnia treated with alprazolam, then zolpidem (20 mg daily for 3 years).
Observation:
- Patient presented with drowsiness, nausea, and vomiting.
- Investigations revealed hyponatremia (low serum sodium) with elevated urine sodium and normal urine osmolarity.
Findings:
- The clinical presentation and laboratory results are consistent with drug-induced Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH).
- Other potential causes of SIADH were systematically excluded.
- WHO causality assessment rated the association between zolpidem and SIADH as "Probable".
Implications:
- High-dose zolpidem use may lead to SIADH, causing potentially severe hyponatremia.
- Clinicians should consider SIADH in patients presenting with these symptoms while on zolpidem.
- Further research is warranted to understand the mechanism and prevalence of zolpidem-induced SIADH.
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