Hyponatremia associated with paroxetine induced by sodium-restricted diet and hypotonic saline.
METHODS
An 89-year-old woman taking paroxetine was admitted to our hospital for femoral neck fracture; her diet became sodium restricted due to hypertension. After admission, the femoral head replacement was performed and hypotonic saline was administered over 2 days. On the fifth day after the operation, severe hyponatremia was observed and treated with oral fluid restriction, furosemide, sodium chloride and paroxetine discontinuance. In a few days, serum sodium concentration returned to baseline level.


CONCLUSIONS
Besides risk factors for SIADH, a sodium-restricted diet and infusions of hypotonic saline in the perioperative period should be considered risk factors for SIADH associated with paroxetine.
Koide
Tetsuro
T
Department of Pharmacy, Kuwana Municipal Hospital, 430 Kitabessyo, Kuwana, 511-0819, Japan. stkoide@m2.cty-net.ne.jp
Wakabayashi
Toru
T
Matsuda
Toru
T
Horiike
Shinichiro
S
Watanabe
Keiko
K
D000369:Aged, 80 and over; D004039:Diet, Sodium-Restricted / Q000009:adverse effects*; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000178:diet therapy; D007010:Hyponatremia / Q000209:etiology*; D007038:Hypotonic Solutions / Q000009:adverse effects; D007177:Inappropriate ADH Syndrome / Q000150:complications; D017374:Paroxetine / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012965:Sodium Chloride / Q000009:adverse effects*
D007038:Hypotonic Solutions; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D012965:Sodium Chloride