title: Hyponatremia upon resumption of paroxetine therapy.
abstract: 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.
authors.affiliation: Division of Neurology, National Hospital Organization Kyushu Cardiovascular Center, 9-1 Shiroyamacho, Kagoshima 892-0853.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Wakita
authors.forename: Hideki
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Rikuzo
authors.initials: R
authors.lastname: Hamada
authors.forename: Hideki
authors.initials: H
authors.lastname: Okatsu
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakajima
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Osame
mesh_terms: 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
chemical_list: D007552:Isotonic Solutions; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D012964:Sodium; D012965:Sodium Chloride