Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case report
Hyponatremia is a significant complication of treatment with serotonin selective reuptake inhibitors (SSRI). We describe a case of a 53-year-old woman that was started on fluoxetine 20 mg/day for depression. Nine days later, the patient started with weakness, nausea, progressing to confusion, inapet...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações
2006-03-01
|
| Series: | Arquivos de Neuro-Psiquiatria |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000100031&tlng=en |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849696873308225536 |
|---|---|
| author | Carlos Alexandre Twardowschy Cristina Buselatto Bertolucci Cleverson de Macedo Gracia Marta Ângela de Souza Brandão |
| author_facet | Carlos Alexandre Twardowschy Cristina Buselatto Bertolucci Cleverson de Macedo Gracia Marta Ângela de Souza Brandão |
| author_sort | Carlos Alexandre Twardowschy |
| collection | DOAJ |
| description | Hyponatremia is a significant complication of treatment with serotonin selective reuptake inhibitors (SSRI). We describe a case of a 53-year-old woman that was started on fluoxetine 20 mg/day for depression. Nine days later, the patient started with weakness, nausea, progressing to confusion, inapetence and vomit. Three hours later she became unresponsive and had a generalized seizure. She was brought to our emergency service. On admission, the patient was normovolemic, without focal motor deficits, but had mild generalized muscle rigidity and Babinski's sign bilaterally. Serum sodium was 105 mmol/L, serum osmolality, 220 mmol/L, and urinary osmolality, 400 mmol/L. The other laboratory exams, chest X-ray, cerebrospinal fluid and cranium tomography were normal. She was found to have fluoxetine-induced SIADH and it was descontinued. We started the hyponatremia correction and, in 5 days, the mental status of the patient gradually returned to a normal baseline, paralleling the resolution of her hyponatremia, without recurrence. Hyponatremia and SIADH should be considered if a patient experiences deterioration in his or her clinical condition while taking SSRI. The use of SSRI antidepressants should be remembered in the differential diagnosis of drug-induced hyponatremia. |
| format | Article |
| id | doaj-art-5a100e4ab6274c8eadaed7323a6146a7 |
| institution | DOAJ |
| issn | 1678-4227 |
| language | English |
| publishDate | 2006-03-01 |
| publisher | Thieme Revinter Publicações |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj-art-5a100e4ab6274c8eadaed7323a6146a72025-08-20T03:19:20ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272006-03-0164114214510.1590/S0004-282X2006000100031Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case reportCarlos Alexandre Twardowschy0Cristina Buselatto Bertolucci1Cleverson de Macedo Gracia2Marta Ângela de Souza Brandão3Nossa Senhora das Graças HospitalNossa Senhora das Graças HospitalNossa Senhora das Graças HospitalNossa Senhora das Graças HospitalHyponatremia is a significant complication of treatment with serotonin selective reuptake inhibitors (SSRI). We describe a case of a 53-year-old woman that was started on fluoxetine 20 mg/day for depression. Nine days later, the patient started with weakness, nausea, progressing to confusion, inapetence and vomit. Three hours later she became unresponsive and had a generalized seizure. She was brought to our emergency service. On admission, the patient was normovolemic, without focal motor deficits, but had mild generalized muscle rigidity and Babinski's sign bilaterally. Serum sodium was 105 mmol/L, serum osmolality, 220 mmol/L, and urinary osmolality, 400 mmol/L. The other laboratory exams, chest X-ray, cerebrospinal fluid and cranium tomography were normal. She was found to have fluoxetine-induced SIADH and it was descontinued. We started the hyponatremia correction and, in 5 days, the mental status of the patient gradually returned to a normal baseline, paralleling the resolution of her hyponatremia, without recurrence. Hyponatremia and SIADH should be considered if a patient experiences deterioration in his or her clinical condition while taking SSRI. The use of SSRI antidepressants should be remembered in the differential diagnosis of drug-induced hyponatremia.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000100031&tlng=enantidepressive agentsfluoxetineinappropriate ADH syndrome |
| spellingShingle | Carlos Alexandre Twardowschy Cristina Buselatto Bertolucci Cleverson de Macedo Gracia Marta Ângela de Souza Brandão Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case report Arquivos de Neuro-Psiquiatria antidepressive agents fluoxetine inappropriate ADH syndrome |
| title | Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case report |
| title_full | Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case report |
| title_fullStr | Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case report |
| title_full_unstemmed | Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case report |
| title_short | Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case report |
| title_sort | severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone siadh associated with fluoxetine case report |
| topic | antidepressive agents fluoxetine inappropriate ADH syndrome |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000100031&tlng=en |
| work_keys_str_mv | AT carlosalexandretwardowschy severehyponatremiaandthesyndromeofinappropriatesecretionofantidiuretichormonesiadhassociatedwithfluoxetinecasereport AT cristinabuselattobertolucci severehyponatremiaandthesyndromeofinappropriatesecretionofantidiuretichormonesiadhassociatedwithfluoxetinecasereport AT cleversondemacedogracia severehyponatremiaandthesyndromeofinappropriatesecretionofantidiuretichormonesiadhassociatedwithfluoxetinecasereport AT martaangeladesouzabrandao severehyponatremiaandthesyndromeofinappropriatesecretionofantidiuretichormonesiadhassociatedwithfluoxetinecasereport |