Selective Serotonin Reuptake Inhibitor-Induced Hyponatremia and the Plastic Surgery Patient

Area of Science:

• Plastic surgery
• Pharmacology
• Endocrinology

Background:

• Cosmetic plastic surgery is increasingly common, with many procedures performed outside hospitals.
• Use of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), is rising significantly.
• SSRIs are widely prescribed for mood and anxiety disorders, with substantial annual expenditure in the US.

Observation:

• Hyponatremia, a decrease in serum sodium levels, is a known side effect of SSRIs.
• This SSRI-induced hyponatremia is linked to blunted suppression of antidiuretic hormone.
• The incidence and clinical relevance of hyponatremia in surgical patients, especially post-plastic surgery, are under-recognized.

Findings:

• The study reviews existing literature on SSRI-associated hyponatremia.
• Two cases of severe postoperative hyponatremia following plastic surgery are presented.
• These cases highlight the potential for serious adverse events in patients using SSRIs.

Implications:

• Patients on SSRIs undergoing plastic surgery may be at increased risk for hyponatremia.
• Preoperative and postoperative monitoring of serum sodium levels is recommended for these patients.
• Early detection and management of hyponatremia are crucial to prevent severe complications, particularly in elderly patients or those with significant fluid shifts.