HYPONATREMIA ASSOCIATED WITH PAROXETINE

Hyponatremia is an uncommon but widely reported complication of select ive serotonin uptake inhibitors (SSRIs), and most of the case reports involve elderly patients. The presentation is usually that of SIADH, b ut the underlying mechanism leading to the syndrome is poorly understo od. Since the use of SSRIs is becoming more popular among elderly depr essed patients and because of the potentially serious consequence of h yponatremia, psychiatrists should be alert to the development of the c omplication and familiarize themselves with its diagnosis and treatmen t. We report two elderly patients who were identified to have hyponatr emia after the commencement of paroxetine, This illustrates the need f or monitoring of plasma sodium level if a patient's clinical condition deteriorates. Other factors possibly related to the hyponatremia are discussed and a review of the diagnosis and management of SSRI-related hyponatremia is included.