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Hyponatremia associated with paroxetine induced by sodium-restricted diet and hypotonic saline

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Abstract

Case description An 89-year-old woman taking paroxetine was admitted to our hospital for femoral neck fracture; her diet became sodium restricted due to hypertension. After admission, the femoral head replacement was performed and hypotonic saline was administered over 2 days. On the fifth day after the operation, severe hyponatremia was observed and treated with oral fluid restriction, furosemide, sodium chloride and paroxetine discontinuance. In a few days, serum sodium concentration returned to baseline level. Conclusions Besides risk factors for SIADH, a sodium-restricted diet and infusions of hypotonic saline in the perioperative period should be considered risk factors for SIADH associated with paroxetine.

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References

  1. Skerritt U, Evans R, Montgomery SA. Selective serotonin reuptake inhibitors in older people. A tolerability perspective. Drug Aging. 1997;10:209–18.

    Article  CAS  Google Scholar 

  2. Odeh M, Seligmann H, Oliven A. Severe life-threatening hyponatremia during paroxetine therapy. J Clin Pharmacol. 1999;39:1290–1.

    Article  CAS  PubMed  Google Scholar 

  3. Bez Y, Aktolga S, Balci M, Nurmedov S, Topçuoglu V. Citalopram-induced SIADH in a hypertensive patient on salt restricted diet. J Psychopharmacol. 2007;21:665–7.

    Article  CAS  PubMed  Google Scholar 

  4. Tolias CM. Severe hyponatremia in elderly patients: cause for concern. Ann R Coll Surg Engl. 1995;77:346–8.

    CAS  PubMed  Google Scholar 

  5. Jacob S, Spinler SA. Hyponatremia associated with selective serotonin-reuptake inhibitors in older adults. Ann Pharmacother. 2006;40:1618–22.

    Article  CAS  PubMed  Google Scholar 

  6. Kubota T, Miyata A. Syndrome of inappropriate secretion of antidiuretic hormone associated with paroxetine. J Anesth. 2006;20:126–8.

    Article  PubMed  Google Scholar 

  7. Arinzon ZH, Lehman YA, Fidelman ZG, Krasnyansky II. Delayed recurrent SIADH associated with SSRIs. Ann Pharmacother. 2002;36:1175–7.

    Google Scholar 

  8. Ayus JC, Arieff AI. Brain damage and postoperative hyponatremia: the role of gender. Neurology. 1996;46:323–8.

    CAS  PubMed  Google Scholar 

  9. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239–45.

    CAS  PubMed  Google Scholar 

  10. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatremia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol. 1999;47:211–7.

    Article  CAS  PubMed  Google Scholar 

  11. Lane N, Allen K. Hyponatremia after orthopaedic surgery. Br Med J. 1999;318:1363–4.

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pharmacy, Kuwana Municipal Hospital, 430 Kitabessyo, Kuwana, 511-0819, Japan

    Tetsuro Koide & Keiko Watanabe

  2. Department of Orthopedics, Kuwana Municipal Hospital, 430 Kitabessyo, Kuwana, 511-0819, Japan

    Toru Wakabayashi & Toru Matsuda

  3. Department of Internal Medicine, Kuwana Municipal Hospital, 430 Kitabessyo, Kuwana, 511-0819, Japan

    Shinichiro Horiike

Authors
  1. Tetsuro Koide
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  2. Toru Wakabayashi
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  3. Toru Matsuda
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  4. Shinichiro Horiike
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  5. Keiko Watanabe
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Correspondence to Tetsuro Koide.

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Koide, T., Wakabayashi, T., Matsuda, T. et al. Hyponatremia associated with paroxetine induced by sodium-restricted diet and hypotonic saline. Pharm World Sci 32, 19–21 (2010). https://doi.org/10.1007/s11096-009-9353-5

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  • DOI: https://doi.org/10.1007/s11096-009-9353-5

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