Severe symptomatic hyponatremia during citalopram therapy

Hyponatremia secondary to the syndrome of inappropriate secretion of antidi uretic hormone (SIADH) is an uncommon complication of treatment with the ne w class of antidepressant agents, the selective serotonin reuptake inhibito rs (SSRls). Most of the reported cases were associated with fluoxetine; onl y 2 have previously been described in association with citalopram. We descr ibe an elderly woman who presented with severe symptomatic hyponatremia cau sed by the SIADH during therapy with citalopram. Because the use of SSRls i s becoming more popular among elderly depressed patients, the present case and the other 2 reported previously emphasize the need for greater awarenes s of the development of this serious and potentially fatal complication als o in association with citalopram therapy and suggest that serum sodium leve ls should be monitored closely in elderly patients during treatment with ci talopram.