Hyponatremia upon resumption of paroxetine therapy.
We present a 79-year-old woman with severe hyponatremia secondary to resumption of treatment with paroxetine, a selective serotonin-reuptake inhibitor antidepressant. Confusion and fatigue followed re-initiation of paroxetine after a 3-month hiatus. Hyponatremia, serum hypoosmolality, and urine hyperosmolality strongly suggested the syndrome of inappropriate secretion of antidiuretic hormone. Hyponatremia was quickly resolved after discontinuation of paroxetine and initiation of intravenous normal saline infusion together with oral fluid restriction. This case underscores the importance of monitoring serum sodium in elderly patients taking paroxetine, whether this represents a new prescription or reintroduction of the drug.
Wakita
Masayuki
M
Division of Neurology, National Hospital Organization Kyushu Cardiovascular Center, 9-1 Shiroyamacho, Kagoshima 892-0853.
Matsuoka
Hideki
H
Hamada
Rikuzo
R
Okatsu
Hideki
H
Nakajima
Takahiro
T
Osame
Mitsuhiro
M
D000368:Aged; D003863:Depression / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D017374:Paroxetine / Q000009:adverse effects* / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012964:Sodium / Q000097:blood; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use
D007552:Isotonic Solutions; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D012964:Sodium; D012965:Sodium Chloride