Selective Serotonin Reuptake Inhibitor-Induced Hyponatremia: Clinical Implications and Therapeutic Alternatives

• Published in: Clinical neuropharmacology Vol. 40; no. 4; p. 177
• Main Authors: Varela Piñón, María, Adán-Manes, Jaime
• Format: Journal Article
• Language: English
• Published: United States 01.07.2017
• Subjects: Aged, 80 and over; Antidepressive Agents, Second-Generation - therapeutic use; Bupropion - therapeutic use; Depression - blood; Depression - diagnosis; Depression - drug therapy; Humans; Hyponatremia - blood; Hyponatremia - chemically induced; Hyponatremia - diagnosis; Male; Serotonin Uptake Inhibitors - adverse effects; Serotonin Uptake Inhibitors - blood
• ISSN: 1537-162X
• DOI: 10.1097/WNF.0000000000000221

Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed among the general population. Despite their benign side effect profile, these drugs can cause significant adverse effects in elderly patients, including severe hyponatremia. We report 1 case of SSRI-induced hyponatremia and review therapeutic alternatives. We present an 81-year-old male patient treated with sertraline and furosemide who presented with a recent-onset symptomatic hyponatremia. Low sodium levels persisted for more than 1 week after furosemide had been discontinued. Sertraline was then replaced with a nonserotonergic antidepressant (bupropion), leading to a full recovery. Although SSRIs are the first treatment option for elderly depressed patients, they should be prescribed cautiously in this population because of the risk of potentially severe adverse effects such as hyponatremia. Particularly vulnerable patients could benefit from being prescribed nonserotonergic antidepressants from the start.