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Severe symptomatic hyponatremia during citalopram therapy - a case report

BACKGROUND: Hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic hormone is an uncommon complication of treatment with the new class of antidepressant agents, the selective serotonin reuptake inhibitors. The risk of hyponatremia seems to be highest during the first weeks...

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Autores principales: Flores, Guillermo, Perez-Patrigeon, Santiago, Cobos-Ayala, Carolina, Vergara, Jesus
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC331411/
https://www.ncbi.nlm.nih.gov/pubmed/14728721
http://dx.doi.org/10.1186/1471-2369-5-2
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author Flores, Guillermo
Perez-Patrigeon, Santiago
Cobos-Ayala, Carolina
Vergara, Jesus
author_facet Flores, Guillermo
Perez-Patrigeon, Santiago
Cobos-Ayala, Carolina
Vergara, Jesus
author_sort Flores, Guillermo
collection PubMed
description BACKGROUND: Hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic hormone is an uncommon complication of treatment with the new class of antidepressant agents, the selective serotonin reuptake inhibitors. The risk of hyponatremia seems to be highest during the first weeks of treatment particularly, in elderly females and in patients with a lower body weight. CASE PRESENTATION: A 61-year-old diabetic male was admitted to the hospital because of malaise, progressive confusion, and a tonic/clonic seizure two weeks after starting citalopram, 20 mg/day. On physical examination the patient was euvolemic and had no evidence of malignancy, cardiac, renal, hepatic, adrenal or thyroid disease. Laboratory tests results revealed hyponatremia, serum hypoosmolality, urine hyperosmolarity, and an elevated urine sodium concentration, leading to the diagnosis of inappropriate secretion of antidiuretic hormone. Citalopram was discontinued and fluid restriction was instituted. The patient was discharged after serum sodium increased from 124 mmol/L to 134 mmol/L. Two weeks after discharge the patient denied any new seizures, confusion or malaise. At that time his serum sodium was 135 mmol/L. CONCLUSIONS: Because the use of serotonin reuptake inhibitors is becoming more popular among elderly depressed patients the present paper and other reported cases emphasize the need of greater awareness of the development of this serious complication and suggest that sodium serum levels should be monitored closely in elderly patients during treatment with citalopram.
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spelling pubmed-3314112004-02-07 Severe symptomatic hyponatremia during citalopram therapy - a case report Flores, Guillermo Perez-Patrigeon, Santiago Cobos-Ayala, Carolina Vergara, Jesus BMC Nephrol Case Report BACKGROUND: Hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic hormone is an uncommon complication of treatment with the new class of antidepressant agents, the selective serotonin reuptake inhibitors. The risk of hyponatremia seems to be highest during the first weeks of treatment particularly, in elderly females and in patients with a lower body weight. CASE PRESENTATION: A 61-year-old diabetic male was admitted to the hospital because of malaise, progressive confusion, and a tonic/clonic seizure two weeks after starting citalopram, 20 mg/day. On physical examination the patient was euvolemic and had no evidence of malignancy, cardiac, renal, hepatic, adrenal or thyroid disease. Laboratory tests results revealed hyponatremia, serum hypoosmolality, urine hyperosmolarity, and an elevated urine sodium concentration, leading to the diagnosis of inappropriate secretion of antidiuretic hormone. Citalopram was discontinued and fluid restriction was instituted. The patient was discharged after serum sodium increased from 124 mmol/L to 134 mmol/L. Two weeks after discharge the patient denied any new seizures, confusion or malaise. At that time his serum sodium was 135 mmol/L. CONCLUSIONS: Because the use of serotonin reuptake inhibitors is becoming more popular among elderly depressed patients the present paper and other reported cases emphasize the need of greater awareness of the development of this serious complication and suggest that sodium serum levels should be monitored closely in elderly patients during treatment with citalopram. BioMed Central 2004-01-16 /pmc/articles/PMC331411/ /pubmed/14728721 http://dx.doi.org/10.1186/1471-2369-5-2 Text en Copyright © 2004 Flores et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Case Report
Flores, Guillermo
Perez-Patrigeon, Santiago
Cobos-Ayala, Carolina
Vergara, Jesus
Severe symptomatic hyponatremia during citalopram therapy - a case report
title Severe symptomatic hyponatremia during citalopram therapy - a case report
title_full Severe symptomatic hyponatremia during citalopram therapy - a case report
title_fullStr Severe symptomatic hyponatremia during citalopram therapy - a case report
title_full_unstemmed Severe symptomatic hyponatremia during citalopram therapy - a case report
title_short Severe symptomatic hyponatremia during citalopram therapy - a case report
title_sort severe symptomatic hyponatremia during citalopram therapy - a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC331411/
https://www.ncbi.nlm.nih.gov/pubmed/14728721
http://dx.doi.org/10.1186/1471-2369-5-2
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