• Rev Med Interne · Sep 2007

    Case Reports

    [Inappropriate ADH secretion-induced hyponatremia and associated with paroxetine use].

    • C Bigaillon, Y El Jahiri, C Garcia, C Hejl-Garcia, H Mayaudon, F Ceppa, and P Burnat.
    • Laboratoire de biochimie, hôpital d'instruction des Armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France. arthur4@tele2.fr
    • Rev Med Interne. 2007 Sep 1; 28 (9): 642644642-4.

    IntroductionSelective serotonin reuptake inhibitors (SSRI) are the most common antidepressants prescribed for elderly people. Although they are generally better tolerated than other antidepressant treatment classes, they can be responsible for potentially life-threatening hyponatremia, related to syndrome of inappropriate antidiuretic hormone secretion (SIADH).ObservationA 64 years-old woman was hospitalized for cognitive function alteration and vomiting after introduction of paroxetine for depressive symptoms. Serum investigations revealed hyponatremia (121 mmol/l) with low plasma osmolarity and normal natriuria consistent with diagnosis of SIADH. Hyponatremia was reversible after paroxetine withdrawal.DiscussionHyponatremia induced by SIADH is a serious but underestimated complication of SSRI treatment. This complication occurs in the elderly people within the first month of treatment. Monitoring of the serum sodium concentration during the first month of treatment is recommended for older patients.

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