ANTIDEPRESSANT-INDUCED HYPONATREMIA IN THE AGED - AVOIDANCE AND MANAGEMENT STRATEGIES

Authors
Citation
H. Sharma et P. Pompei, ANTIDEPRESSANT-INDUCED HYPONATREMIA IN THE AGED - AVOIDANCE AND MANAGEMENT STRATEGIES, Drugs & aging, 8(6), 1996, pp. 430-435
Citations number
26
Categorie Soggetti
Pharmacology & Pharmacy","Geiatric & Gerontology
Journal title
ISSN journal
1170229X
Volume
8
Issue
6
Year of publication
1996
Pages
430 - 435
Database
ISI
SICI code
1170-229X(1996)8:6<430:AHITA->2.0.ZU;2-E
Abstract
Antidepressant-induced hyponatraemia, while relatively uncommon, is an important clinical problem with serious consequences. Most antidepres sants have been associated with hyponatraemia. Although the exact mech anism by which abnormalities of serum sodium level are produced is not known, most of the patients described in case reports meet the accept ed criteria for the syndrome of inappropriate antidiuretic hormone sec retion. Symptoms of hyponatraemia can mimic depression of psychosis, s o awareness of this syndrome and periodic monitoring of serum electrol ytes are important for early recognition. Stopping the medication and assuring normal extracellular fluid volume are the mainstay of treatme nt; rarely, intravenous infusion of hypertonic saline is required. Aft er correcting the metabolic abnormalities, options for treatment of de pression include: rechallenging with the same medication or initiating another antidepressant while carefully monitoring serum sodium level, or considering electroconvulsive therapy, if warranted by the clinica l condition.