Severe life-threatening hyponatremia during paroxetine therapy

Hyponatremia secondary to the syndrome of inappropriate secretion of antidu retic hormone (SIADH) is an uncommon complication of treatment with the ant idepressants the selective serotonin reuptake inhibitors (SSRIs). These eff ective antidepressant agents are becoming widely used because of their favo rable side effect profile and their safety in overdose, Although most repor ts have implicated fluoxetine in causing hyponatremia, there have also been a few reports of hyponatremia associated with paroxetine. We describe an e lderly patient with severe life-threatening hyponatremia in association wit h paroxetine therapy. The present case and the others previously reported e mphasize the need;for greater awareness of the development of this serious and potentially fatal complication, and suggest that serum sodium concentra tion should be measured periodically in elderly patients soon after they st art taking any agent of the SSRIs, especially during the first 2 to 4 weeks of treatment. (C) 1999 the American College of Clinical Pharmacology.