title: Antidepressants and the risk of hyponatremia: a Danish register-based population study.
abstract: To examine the association between classes of antidepressants and hyponatremia, and between specific antidepressants and hyponatremia.
  
  
  
  Retrospective register-based cohort study using nationwide registers from 1998 to 2012.
  
  
  
  The North Denmark Region.
  
  
  
  In total, 638 352 individuals were included.
  
  
  
  Plasma sodium was obtained from the LABKA database. The primary outcome was hyponatremia defined as plasma sodium (p-sodium) below 135 mmol/L and secondary outcome was severe hyponatremia defined as p-sodium below 130 mmol/L. The association between use of specific antidepressants and hyponatremia was analysed using multivariable Poisson regression models.
  
  
  
  An event of hyponatremia occurred in 72 509 individuals and 11.36% (n=6476) of these events happened during treatment with antidepressants. Incidence rate ratios and CIs for the association with hyponatremia in the first p-sodium measured after initiation of treatment were for citalopram 7.8 (CI 7.42 to 8.20); clomipramine 4.93 (CI 2.72 to 8.94); duloxetine 2.05 (CI 1.44 to 292); venlafaxine 2.90 (CI 2.43 to 3.46); mirtazapine 2.95 (CI 2.71 to 3.21); and mianserin 0.90 (CI 0.71 to 1.14).
  
  
  
  All antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine.
authors.affiliation: Department of Geriatric Medicine, Nykøbing Falster Hospital, Nykøbing Falster, Denmark.
authors.forename: Katja Biering
authors.initials: KB
authors.lastname: Leth-Møller
authors.affiliation: Department of Geriatric Medicine, Slagelse Hospital, Slagelse, Denmark.
authors.forename: Annette Højmann
authors.initials: AH
authors.lastname: Hansen
authors.affiliation: Department of Geriatric Medicine, Nykøbing Falster Hospital, Nykøbing Falster, Denmark.
authors.forename: Maia
authors.initials: M
authors.lastname: Torstensson
authors.affiliation: Clinical Pharmacology Unit, University Hospital Zealand, Roskilde, Denmark.
authors.forename: Stig Ejdrup
authors.initials: SE
authors.lastname: Andersen
authors.affiliation: Department of Biochemistry, University Hospital Zealand, Roskilde, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Ødum
authors.affiliation: Department of Cardiology, Gentofte Hospital, Hellerup, Denmark.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Gislasson
authors.affiliation: Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Geriatric Medicine, Nykøbing Falster Hospital, Nykøbing Falster, Denmark.
authors.forename: Ellen Astrid
authors.initials: EA
authors.lastname: Holm
mesh_terms: D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use; D002997:Clomipramine / Q000627:therapeutic use; D003718:Denmark / Q000453:epidemiology; D000068736:Duloxetine Hydrochloride / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000627:therapeutic use*; D012964:Sodium / Q000097:blood; D000069470:Venlafaxine Hydrochloride / Q000627:therapeutic use
chemical_list: D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D002997:Clomipramine; D000068736:Duloxetine Hydrochloride; D008803:Mianserin; D000078785:Mirtazapine; D017367:Selective Serotonin Reuptake Inhibitors; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D012964:Sodium; D000069470:Venlafaxine Hydrochloride
keywords: Hyponatremia