title: Syndrome of inappropriate antidiuresis in doxylamine overdose.
abstract: Doxylamine succinate, an H(1)-antihistamine drug, is commonly used as sleep-inducing agent as well as therapy for nausea and vomiting in pregnancy. At usual doses, it may cause impairment of cognitive and psychomotor performance, anticholinergic effects, agitation and postural hypotension. Besides, since this drug is frequently involved in either accidental or intentional overdoses, it seems relevant to bear in mind other possible toxic effects. We report a case of acute severe hyponatremia in the setting of a syndrome of inappropriate antidiuresis (SIAD), an apparent new adverse effect linked to doxylamine overdose. The Naranjo adverse drug reaction probability scale indicated a probable relationship between doxylamine intake and SIAD development. SIAD may be considered as a potential, serious adverse reaction of doxylamine overdose. Clinicians should consider this aetiological possibility when attending patients suffering from hyponatremia.
authors.affiliation: Department of Internal Medicine, Hospital of Laredo, Laredo, Cantabria, Spain. miguel.carrascosa@scsalud.es
authors.forename: Miguel F
authors.initials: MF
authors.lastname: Carrascosa
authors.forename: José-Ramón Salcines
authors.initials: JR
authors.lastname: Caviedes
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Lucena
authors.forename: Antonio
authors.initials: A
authors.lastname: Cuadrado-Lavín
mesh_terms: D000368:Aged; D004305:Dose-Response Relationship, Drug; D004319:Doxylamine / Q000031:analogs & derivatives* / Q000633:toxicity; D062787:Drug Overdose / Q000150:complications*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006993:Hypnotics and Sedatives / Q000633:toxicity*; D007010:Hyponatremia / Q000139:chemically induced* / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy
chemical_list: D006993:Hypnotics and Sedatives; D012462:Saline Solution, Hypertonic; D004319:Doxylamine; C035385:doxylamine succinate