Three cases of severe hyponatremia under taking selective serotonin reuptake inhibitor (SSRI)

Daijo Inaguma, Wataru Kitagawa, Hiroki Hayashi, Toshikazu Kanoh, Kei Kurata, Shinichi Kumon

研究成果: ジャーナルへの寄稿学術論文査読

10 被引用数 (Scopus)

抄録

The association between selective serotonin reuptake inhibitors(SSRIs)and hyponatremia has been documented throughout the world. In Japan, since SSRIs have recently come into use for patients with depression, there are only a few reports of hyponatremia associated with SSRIs. We present here three cases of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with the administration of fluvoxamine for depression. They were admitted to our hospital because of deep coma, and revealed severe hyponatremia. Their serum sodium levels were 103∼112 mEq/l, serum osmolalities were 227∼241 mmol/kg, urine sodium levels were 38∼107 mEq/l, and urine osmolalities were 352∼781 mmol/kg. These patients were started on fiuvoxamine 3 days∼3 months previously. The diagnosis of SIADH in these patients was made based on hyponatremia, and low serum and high urine osmolalities. The fluvoxamine treatment was discontinued, and hypertonic saline was infused. Their serum sodium levels and osmolalities were subsequently normalized. None of the other known causes of hyponatremia, including diuretic therapy, tumors, and respiratory and central nervous system diseases, were present. High plasma AVP levels observed in the two cases suggest that SSRIs stimulate AVP secretion, thereby causing SIADH. Many reports have shown that people older than 70 years were at a particularly high risk of developing hyponatremia when SSRIs were used. In the future, since the use of SSRIs will be increasing, the water and electrolyte balance of elderly patients should be monitored carefully during SSRIs therapy.

本文言語英語
ページ(範囲)644-648
ページ数5
ジャーナルJapanese Journal of Nephrology
42
8
出版ステータス出版済み - 2000
外部発表はい

All Science Journal Classification (ASJC) codes

  • 腎臓病学

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