Hyponatraemia in elderly psychiatric patients treated with Selective Serotonin Reuptake Inhibitors and venlafaxine: a retrospective controlled study in an inpatient unit

Kirby, Dianne; Harrigan, Susy; Ames, David

doi:10.1002/gps.591

Cited by 125 publications

(66 citation statements)

References 6 publications

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“…Despite the apparent clinical significance of the issue, our knowledge on prevalence, risk factors, and drugs involved in treatment-related hyponatremia is mainly confined to antidepressants, in particular SSRIs and venlafaxine. 6 Elderly patients are particularly at risk for hyponatremia in general, since many are taking diuretics for hypertension, while some studies have shown to increase the risk of SSRI-associated hyponatremia. Loss of renal function, polypharmacy, dementia, and other conditions of advanced age can either exacerbate the severity of hyponatremia or mask its onset.…”

Section: Introductionmentioning

confidence: 99%

A case series on drug induced hyponatremia: uncommon adverse effect of commonly used drugs

Joshi

Gupta

Malhotra

et al. 2018

Int J Basic Clin Pharmacol

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Older patients suffering from depression and psychosis have markedly increased since last decade. So, has the use of antidepressants and antipsychotics. The prevalence of hyponatremia due to these drugs is common in general as well as psychiatric practice. It may also lead to life threatening morbidity and mortality. Loss of renal function, polypharmacy, dementia and other conditions of advanced age can either exacerbate the severity of hyponatremia or mask its onset. In this case series, total four cases were reported of hyponatremia and drugs causing it were escitalopram, quetiapine, tianeptine and oxcarbazepine. Due to polypharmacy, a chance of hyponatremia was more in these patients. Patients received infusion of hypertonic saline with salt added diet to treat hyponatremia. Symptoms of hyponatremia were improved after the treatment. In all four cases, WHO and Naranjo’s causality assessment revealed ‘possible’ causal relationship with the prescribed drug. Prescribers should be aware of such adverse effect due to these drugs.

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Section: Introductionmentioning

confidence: 99%

A case series on drug induced hyponatremia: uncommon adverse effect of commonly used drugs

Joshi

Gupta

Malhotra

et al. 2018

Int J Basic Clin Pharmacol

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show abstract

“…In the same study, it was also shown that venlafaxine is more likely to have a hyponatremiaside effects than serotonin reuptake inhibitors [32]. This is probably due to the extra noradrenergic component of venlafaxine mechanism of action.…”

Section: Siadh and Antidepressantsmentioning

confidence: 85%

“…ryzyko rozwoju hiponatremii wśród pacjentów stosujących SSRI lub wenlafaksynę jest 5,6 razy większe, niż w grupie pacjentów niestosujących tych leków przeciwne presyjnych. W tym samym badaniu wykazano również że wenlafaksyna częściej daje skutek uboczny w postaci hiponatremii niż inhibitory wychwytu zwrotnego serotoniny [32].…”

Section: Przyczynyunclassified

Hiponatremia in the practice of a psychiatrist. Part 1: SIADH syndrome and drug-induced hyponatremia.

Stelmach

Hołownia

Słotwiński

et al. 2017

Current Problems of Psychiatry

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Introduction. Hyponatremia is an important part of psychiatric practice. In order to analyze its causes and symptoms, the literature on hyponatremia in psychiatric patients has been reviewed. The work has been divided into two separate manuscripts. In the first one the authors discuss the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and hyponatremia occurring with the use of psychotropic drugs (antidepressants, antipsychotics, normotimics), while the second paper discusses research on psychogenic polydipsia. The causes of hyponatremia in patients treated in psychiatric wards include: water intoxication associated with polydipsia, somatic comorbidities, side effect of internal medicine and psychiatric drugs. The most common mechanism leading in these cases to hyponatremia is the syndrome of inappropriate secretion of vasopressin (SIADH). The SIADH syndrome is a group of symptoms, first described in 1967 by Schwartz and Bartter in The American Journal of Medicine, which results from the hypersecretion of antidiuretic hormone, also called vasopressin, which causes patients to develop normovolemic hyponatremia. The phenomenon of drug-induced hyponatremia in psychiatric practice is generally observed with the use of antidepressants, antipsychotics and anti-epileptic drugs (used in psychiatry as normotimic drugs).Aim and method. The first manuscript includes a review of literature on the syndrome of inappropriate secretion of vasopressin (SIADH) and hyponatremia occurring after the use of psychotropic drugs, and is divided into two subsections: 1. The syndrome of inappropriate secretion of vasopressin (SIADH), 2. Hyponatremia and psychotropic drugs (antidepressants, antipsychotics, normotimics).Conclusion. In the view of the reviewed literature it is extremely important to control the natremia level during pharmacotherapy using the above mentioned drugs, especially in the initial period of therapy.

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“…As age advances, the renal function gradually decreases and this may increase the risk of elderly patients developing hyponatremia secondary to a syndrome of inappropriate antidiuretic hormone(SIADH) secretion. This syndrome is more common in patients receiving SSRIs and venlafaxine and on an average about 10% of patients 590 may develop this [33]. The risk of gastrointestinal bleeding increased in patients receiving SSRIs, more so in individuals with a history of peptic ulcer or in those who receive non-steroidal anti-inflammatory drugs(NSAIDS).…”

Section: How To Choose Antidepressants:-mentioning

confidence: 99%

Treatment of Depression in Elderly.

Bairy¹,

Bairy²

2017

IJAR

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Hyponatraemia in elderly psychiatric patients treated with Selective Serotonin Reuptake Inhibitors and venlafaxine: a retrospective controlled study in an inpatient unit

Cited by 125 publications

References 6 publications

A case series on drug induced hyponatremia: uncommon adverse effect of commonly used drugs

A case series on drug induced hyponatremia: uncommon adverse effect of commonly used drugs

Hiponatremia in the practice of a psychiatrist. Part 1: SIADH syndrome and drug-induced hyponatremia.

Treatment of Depression in Elderly.

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