Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs

Giorlando, Francesco, Teister, Julia, Dodd, Seetal, Udina, Marc and Berk, Michael 2013, Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs, Current drug safety, vol. 8, no. 3, pp. 175-180.

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Title Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs
Author(s) Giorlando, Francesco
Teister, Julia
Dodd, Seetal
Udina, Marc
Berk, Michael
Journal name Current drug safety
Volume number 8
Issue number 3
Start page 175
End page 180
Total pages 6
Publisher Bentham Science
Place of publication Bussum, The Netherlands
Publication date 2013
ISSN 1574-8863
2212-3911
Keyword(s) hyponatraemia
major depression
SNRI
sodium
SSRI
Summary Objective
Hyponatraemia is a serious adverse event commonly reported in elderly people treated with serotonergic antidepressants. The mechanism, incidence and risk factors for antidepressant induced hyponatraemia are not fully understood.

Method:
In a retrospective chart analysis, depressed patients aged >63 years were investigated for change in serum sodium levels between two time points, separated by a median period of 45.5 days, with the first specimen taken prior to treatment. Patients were grouped into three cohorts; treated with an SSRI or SNRI (n=77), treated with an antidepressant other than an SSRI or SNRI (n=54) and not treated with an antidepressant (n=128).

Results:
For change in sodium level between measurements and total number of patients with hyponatraemia, there was no significant difference between cohorts. However, the rate of reduction of serum sodium levels between time points was significantly greater for SSRI and SNRI treated patients (p<0.001) and patients treated with other antidepressants (p=0.03) compared to patients not treated with antidepressants. Moreover, the distribution of values of change in serum sodium was skewed towards reduced serum sodium in patients treated with SSRI or SNRIs (skew -0.43) and patients treated with other antidepressants (skew -0.09) but not for patients without antidepressants (skew 0.25).

Conclusions:
These data suggest that antidepressant treatment is associated with hyponatraemia affecting a subgroup of individuals only. Generalised linear modelling showed that the risk of hyponatraemia increases with increased age, female gender, and particularly the antidepressant agents sertraline and escitalopram. The findings are of clinical significance as they demonstrate that hyponatraemia can occur rapidly with antidepressants, and SSRI/SNRI medications induce more rapid changes. They support the use of electrolyte monitoring early in antidepressant treatment in patients receiving antidepressants.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Bentham Science
Persistent URL http://hdl.handle.net/10536/DRO/DU:30059527

Document type: Journal Article
Collection: School of Medicine
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