OBJECTIVES: The aims of this study were to describe the characteristics of hyponatremia in elderly users of antidepressants, to determine the prevalence and risk factors for hyponatremia, and to identify the underlying mechanisms. STUDY DESIGN: Cross-sectional study (March 2007-April 2009) with prospectively collected data. Patients were older than 60 years, used antidepressants, and had a complete geriatric assessment. MAIN OUTCOME MEASURES: Serum sodium and antidiuretic hormone levels, serum osmolality, urine sodium level, and urine osmolality were measured. The prevalence of hyponatremia (serum sodium <135 mM) as an adverse reaction to an antidepressant (AR-AD), defined with Naranjo's algorithm, was calculated. Hyponatremic patients were compared to normonatremic patients with regard to gender, age, weight, history of hyponatremia, hyponatremia-associated medications and disorders, and type and duration of antidepressant use. RESULTS: Of 358 eligible patients, 345 were included. The prevalence of hyponatremia as an AR-AD was 9.3%. Risk factors were a history of hyponatremia (adjusted OR 11.17, 95%CI 2.56-40.41), weight<60 kg (adjusted OR 3.47, 95%CI 1.19-10.13), and psychosis (adjusted OR 3.62, 95%CI 1.12-11.73). Non-suppressed ADH was found in a minority of hyponatremic patients. CONCLUSIONS: In elderly patients, the prevalence of hyponatremia as adverse reaction to all types of antidepressants was 9%. Patients with previous hyponatremia, weight <60 kg, and psychosis were at risk. Beside SIADH, the nephrogenic syndrome of inappropriate antidiuresis, in which ADH secretion was normal, is postulated as an underlying mechanism. This has consequences for treatment of antidepressant-induced hyponatremia with vasopressin receptor antagonists.
OBJECTIVES: The aims of this study were to describe the characteristics of hyponatremia in elderly users of antidepressants, to determine the prevalence and risk factors for hyponatremia, and to identify the underlying mechanisms. STUDY DESIGN: Cross-sectional study (March 2007-April 2009) with prospectively collected data. Patients were older than 60 years, used antidepressants, and had a complete geriatric assessment. MAIN OUTCOME MEASURES: Serum sodium and antidiuretic hormone levels, serum osmolality, urine sodium level, and urine osmolality were measured. The prevalence of hyponatremia (serum sodium <135 mM) as an adverse reaction to an antidepressant (AR-AD), defined with Naranjo's algorithm, was calculated. Hyponatremic patients were compared to normonatremic patients with regard to gender, age, weight, history of hyponatremia, hyponatremia-associated medications and disorders, and type and duration of antidepressant use. RESULTS: Of 358 eligible patients, 345 were included. The prevalence of hyponatremia as an AR-AD was 9.3%. Risk factors were a history of hyponatremia (adjusted OR 11.17, 95%CI 2.56-40.41), weight<60 kg (adjusted OR 3.47, 95%CI 1.19-10.13), and psychosis (adjusted OR 3.62, 95%CI 1.12-11.73). Non-suppressed ADH was found in a minority of hyponatremic patients. CONCLUSIONS: In elderly patients, the prevalence of hyponatremia as adverse reaction to all types of antidepressants was 9%. Patients with previous hyponatremia, weight <60 kg, and psychosis were at risk. Beside SIADH, the nephrogenic syndrome of inappropriate antidiuresis, in which ADH secretion was normal, is postulated as an underlying mechanism. This has consequences for treatment of antidepressant-induced hyponatremia with vasopressin receptor antagonists.
Authors: Valentina Buda; Andreea Prelipcean; Carmen Cristescu; Alexandru Roja; Olivia Dalleur; Minodora Andor; Corina Danciu; Adriana Ledeti; Cristina Adriana Dehelean; Octavian Cretu Journal: Int J Environ Res Public Health Date: 2021-07-01 Impact factor: 3.390
Authors: Andrea Christine Shysh; Zahinoor Ismail; Davinder Sidhu; Maggie Guo; Leonard T Nguyen; Christopher Naugler Journal: Drugs Real World Outcomes Date: 2021-05-23
Authors: Katja Biering Leth-Møller; Annette Højmann Hansen; Maia Torstensson; Stig Ejdrup Andersen; Lars Ødum; Gunnar Gislasson; Christian Torp-Pedersen; Ellen Astrid Holm Journal: BMJ Open Date: 2016-05-18 Impact factor: 2.692
Authors: Johanna Seifert; Martin Letmaier; Timo Greiner; Michael Schneider; Maximilian Deest; Christian K Eberlein; Stefan Bleich; Renate Grohmann; Sermin Toto Journal: J Neural Transm (Vienna) Date: 2021-07-01 Impact factor: 3.575