Syndrome of inappropriate secretion of antidiuretic hormone associated with paroxetine.
A 71-year old man with failed back syndrome was admitted to hospital with oliguria that had occurred 4 days after his dose of paroxetine had been increased to 40 mg x day(-1). Laboratory data on admission revealed hyponatremia (124 mmol x l(-1)), low serum osmolarity (267 mOsm x l(-1)) with a normal level of serum antidiuretic hormone (1.7 pg x ml(-1)), and concentrated urine (430 mOsm x l(-1)). He was diagnosed as having syndrome of inappropriate secretion of antidiuretic hormone, associated with paroxetine; this drug was discontinued immediately after admission. The hyponatremia was treated with saline infusion, water restriction, and furosemide; serum sodium level returned to normal on hospital day 5. Paroxetine is being increasingly used for depression and chronic pain management because of its favorable side-effect profile; however, we should be alert to hyponatremia in patients on paroxetine by carrying out periodic monitoring of serum electrolytes, especially in elderly patients.
Kubota
Takeshi
T
Department of Anesthesia, Hachinohe Heiwa Hospital, 4-6 Minatotakadai 2-chome, Hachinohe 031-8545, Japan.
Miyata
Akimasa
A
D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D002908:Chronic Disease; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D004573:Electrolytes / Q000097:blood; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced*; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery; D008297:Male; D010146:Pain / Q000150:complications / Q000188:drug therapy; D017374:Paroxetine / Q000009:adverse effects*; D012964:Sodium / Q000097:blood; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery; D014667:Vasopressins / Q000097:blood
D018687:Antidepressive Agents, Second-Generation; D004573:Electrolytes; D014667:Vasopressins; D017374:Paroxetine; D012964:Sodium