title: Selective Serotonin Reuptake Inhibitor-Induced Hyponatremia and the Plastic Surgery Patient.
abstract: Cosmetic plastic surgery procedures continue to increase in frequency, and a greater number of them now occur outside of an acute-care hospital setting. In addition, antidepressant use is also rising, with a greater number of patients taking selective serotonin reuptake inhibitors to aid in a variety of mood and anxiety disorders. Americans spend more than $86 billion each year on antidepressants, as 34 million people in the United States are taking at least one of these medications. Many side effects of selective serotonin reuptake inhibitors are well known and not clinically relevant to practicing surgeons. Hyponatremia, however, is a well-documented side effect of these medications that has received relatively little attention in the surgical literature. Postoperative hyponatremia results because of a decrease of antidiuretic hormone suppression that occurs with selective serotonin reuptake inhibitor administration. Here, the authors first review the literature reporting hyponatremia with selective serotonin reuptake inhibitor use. The authors then present two cases of severe postoperative hyponatremia after plastic surgery operations. The authors propose that patients using selective serotonin reuptake inhibitors, especially elderly patients and those undergoing procedures with expected large fluid shifts, should be tested preoperatively and postoperatively for serum sodium levels so that a diagnosis of hyponatremia may be made early and treated before a catastrophic event.
  
  
  METHODS
  Therapeutic, V.
authors.affiliation: New York, N.Y.|From the Department of Plastic Surgery, Lenox Hill Hospital; the Hansjörg Wyss Department of Plastic Surgery, New York University Medical Center; and anesthesia private practice.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Levine
authors.affiliation: New York, N.Y.|From the Department of Plastic Surgery, Lenox Hill Hospital; the Hansjörg Wyss Department of Plastic Surgery, New York University Medical Center; and anesthesia private practice.
authors.forename: Sammy
authors.initials: S
authors.lastname: Sinno
authors.affiliation: New York, N.Y.|From the Department of Plastic Surgery, Lenox Hill Hospital; the Hansjörg Wyss Department of Plastic Surgery, New York University Medical Center; and anesthesia private practice.
authors.forename: Dominick
authors.initials: D
authors.lastname: Cannavo
authors.affiliation: New York, N.Y.|From the Department of Plastic Surgery, Lenox Hill Hospital; the Hansjörg Wyss Department of Plastic Surgery, New York University Medical Center; and anesthesia private practice.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Baker
mesh_terms: D061645:Abdominoplasty / Q000009:adverse effects / Q000379:methods; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D013518:Surgery, Plastic / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors