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Paroxetine-induced
hyponatremia in the elderly due to the syndrome of inappropriate
secretion of antidiuretic hormone (SIADH).
Fabian
TJ, Amico JA, Kroboth PD, Mulsant BH, Reynolds CF 3rd, Pollock
BG.
Intervention Research Center for Late Life Mood
Disorders, USA. fabiant@msx.upmc.edu
This study investigated the
development of hyponatremia and its underlying mechanism in elderly
patients prescribed paroxetine. Patients were 15 men and women (mean
age, 75.7 +/- 5.3 years) who were participants in a treatment study of
late-life depression and who were without medical illness or other
medications known to cause hyponatremia or alter antidiuretic hormone
(ADH) secretion. Blood samples for measurement of plasma sodium, ADH,
blood urea nitrogen (BUN), creatinine, glucose, and osmolality were
determined prior to initiation of paroxetine (week 0) and at 2, 4, 6,
and 12 weeks of treatment with paroxetine. Hyponatremia (serum sodium
< 135 mEq/L) was identified in 6 of 15 patients after 2 weeks of
treatment with paroxetine. Despite low plasma osmolality, ADH levels
were not suppressed appropriately. Data suggest hyponatremia is a common
adverse event in elderly patients prescribed paroxetine and implicates
inappropriate secretion of ADH as the potential
mechanism.
Publication Types:
PMID: 12967059 [PubMed - indexed for
MEDLINE]
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