Medication-induced SIADH: distribution and characterization according to medication class.
The aims of the current study were to determine the distribution of aetiologies for the drug-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH) in hospitalized patients, and to characterize them according to the different drug groups.



A single-centre retrospective study was carried out, including all patients diagnosed with SIADH in a large community hospital and tertiary centre between 1 January 2007 and 1 January 2013 who were treated with drugs known to be associated with SIADH. Two physicians reviewed every patient's medical file for predetermined relevant clinical data.



The study cohort included 198 patients who had SIADH and received drugs associated with SIADH. Most patients [146 (73.7%)] were diagnosed with drug-associated SIADH, while 52 (26.3%) were diagnosed with SIADH due to other aetiologies. The Naranjo algorithm differentiated well between the two groups (P < 0.001). Five drug classes (antidepressants, anticonvulsants, antipsychotic agents, cytotoxic agents and pain medications) were implicated in 82.3% of patients diagnosed with drug-associated SIADH. Specific serotonin reuptake inhibitors and carbamazepine were commonly implicated. There were no clinically significant differences in the characteristics or severity of SIADH according to drug class.



The clinical characteristics of SIADH caused by different drugs are comparable. Patients with SIADH treated with drugs from five common medication classes will probably be diagnosed with drug-induced SIADH. Physicians should be aware of the significance of these medication classes as SIADH aetiologies.
Medicine A, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Daniel
D
Shepshelovich
Medicine A, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
Amir
A
Schechter
Medicine A, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.|Pharmacy Service, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.|School of Pharmacy, the Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Bronislava
B
Calvarysky
Medicine A, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.|Institute of Endocrinology, Diabetes and Metabolism, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
Talia
T
Diker-Cohen
Department of Nephrology, Rabin Medical Center, Petah-Tikva, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Benaya
B
Rozen-Zvi
Medicine A, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Anat
A
Gafter-Gvili
D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D002220:Carbamazepine / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D007177:Inappropriate ADH Syndrome / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
D000700:Analgesics; D000927:Anticonvulsants; D000928:Antidepressive Agents; D000970:Antineoplastic Agents; D014150:Antipsychotic Agents; D002220:Carbamazepine; D017367:Selective Serotonin Reuptake Inhibitors
SIADH; distribution; hyponatraemia; medications