[Severe and recent hyponatremia and hypokalemia associated to the use of hydrochlorothiazide, enalapril and citalopram. Clinical case].
We report a 72 years old hypertensive female, treated with enalapril 10 mg/day and hydrochlorothiazide 25 mg/day during three years. She presented a depressive disorder and cytalopram was prescribed in a dose of 10 mg/day. Two weeks before admission, a serum electrolyte analysis disclosed normal results and the cytalopram dose was increased to 20 mg/day. The patient was admitted with a hyponatremic encephalopathy with a plasma sodium of 100 mEq/L and a plasma potassium of 2.0 mEq/L. Cytalopram, enalapril and hydrochlorothiazide were discontinued, hypertonic NaCl and KCl were administered. The patient had a favorable evolution with a remarkable improvement of her symptoms.
Riquelme
A
A
Departamento de Nefrología, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Méndez
F
F
Ortiz
A M
AM
Müller
H
H
Campos
C
C
Rocha
V
V
Valdivieso
A
A
D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D015283:Citalopram / Q000009:adverse effects*; D004656:Enalapril / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects*; D007008:Hypokalemia / Q000139:chemically induced*; D007010:Hyponatremia / Q000139:chemically induced*; D012720:Severity of Illness Index; D013997:Time Factors
D018687:Antidepressive Agents, Second-Generation; D000959:Antihypertensive Agents; D015283:Citalopram; D006852:Hydrochlorothiazide; D004656:Enalapril