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Syndrome of Inappropriate Antidiuretic Hormone Associated with Escitalopram Therapy

Published online by Cambridge University Press:  07 November 2014

Abstract

Escitalopram is the selective serotonin reuptake inhibitor (SSRI) most recently approved for use in the United States. It is structurally related to citalopram, but is felt to have a more tolerable side-effect profile than its parent compound. Side effects are not generally serious and include headache, diarrhea, and nausea. While hyponatremia and the syndrome of inappropriate antidiuretic hormone (SIADH) have been associated with treatment with other SSRIs, there has only been one case of escitalopram-induced SIADH reported in the literature to date. We now report another case of a patient who developed SIADH after being treated with escitalopram for 4 weeks. The patient's hyponatremia improved following the discontinuation of escitalopram. Clinicians should be aware of this uncommon but significant side effect of SSRIs and monitor high-risk patients for the development of SIADH.

Type
Case Report
Copyright
Copyright © Cambridge University Press 2006

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References

REFERENCES

1.Llorca, PM, Azorin, JM, Despiegel, N, Verpillat, P. Efficacy of escitalopram in patients with severe depression: a pooled analysis. Int J Clin Pract. 2005;59:268275.CrossRefGoogle ScholarPubMed
2.Roseboom, PH, Kalin, NH. Citalopram and S-Citalopram. In: Schatzberg, AF, Nemeroff, CB, eds. The American Psychiatric Publishing Textbook of Psychopharmacology. 3rd ed. Arlington, Va: American Psychiatric Publishing, Inc.: 2004:291302.Google Scholar
3.Nahshoni, E, Weizman, A, Shefet, D, Pik, N. A case of hyponatremia associated with escitalopram. J Clin Psychiatry. 2004;65:1722.Google Scholar
4.Gommans, JH, Edwards, RA. Fluoxetine and hyponatremia. N Z Med J. 1990;103:106.Google Scholar
5.Burke, D, Fanker, S. Fluoxetine and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Aust N Z J Psychiatry. 1996;30:295298.Google Scholar
6.Catalano, G, Kanfer, SN, Catalano, MC, Alberts, VA. The role of sertraline in a patient with recurrent hyponatremia. Gen Hosp Psychiatry. 1996;18:278283.Google Scholar
7.Thornton, SL, Resch, DS. SIADH associated with sertraline therapy. Am J Psychiatry. 1995;152:809.Google Scholar
8.Malik, AR, Wolf, PK, Ravasia, S. Recurrent paroxetine-induced hyponatremia. Can J Psychiatry. 2004;49:785.Google Scholar
9.Monmany, J, Vazquez, G, Rodriguez, J, Domingo, P. Syndrome of inappropriate secretion of antidiuretic hormone induced by paroxetine. Arch Intern Med. 1999;159:20892090.Google Scholar
10.McHardy, KC, Baliga, RR. Syndrome of inappropriate antidiuretic hormone secretion due to fluvoxamine therapy. Br J Clin Pract. 1993;47:6263.Google Scholar
11.Ball, CJ. Fluvoxamine and SIADH [comment]. Br J Clin Pract. 1993;47:227.Google Scholar
12.Iraqi, A, Baickle, E. A case of hyponatremia with citalopram use. J Am Med Dir Assoc. 2004;5:6465.Google Scholar
13.Barclay, TS, Lee, AJ. Citalopram-associated SIADH. Ann Pharmacother. 2002;36:15581563.Google Scholar
14.Singer, G, Brenner, BM. Fluid and electrolyte disturbances. In: Braunwald, E, Fauci, A, Kasper, D, et al, eds. Harrison's Principles of Internal Medicine. 15th ed. New York, NY: McGraw Hill Professional Publishing: 2001:271283.Google Scholar
15.Liu, BA, Mittmann, N, Knowles, SR, et al.Hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone associated with the use of selective serotonin reuptake inhibitors: a review of spontaneous reports. CMAJ. 1996;155:519527.Google ScholarPubMed
16.Gupta, A, Saravay, S. Venlafaxine-induced hyponatremia. J Clin Psychopharmacol. 1997;17:223225.Google Scholar
17.Madhusoodanan, S, Bogunovic, OJ, Moise, D, Brenner, R, Markowitz, S, Sotelo, J. Hyponatremia associated with psychotropic medications. Adverse Drug React Toxicol Rev. 2002;21(1–2):1729.Google Scholar
18.Spigset, O, Hedenmalm, K. Hyponatremia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by psychotropic drugs. Drug Saf. 1995;12:209225.Google Scholar
19.Mace, S, Taylor, D. Selective serotonin reuptake inhibitors: a review of efficacy and tolerability in depression. Expert Opin Pharmacother. 2000;1:917933.Google Scholar
20.Wilmer, W. Primary glomerular diseases. In: Rakel, RE, Bope, ET, eds. Conn's Current Therapy. Philadelphia, Penn: W.B. Saunders Company: 2002:684685.Google Scholar
21.Schouten, WE, Sepers, JM. Hyponatremia associated with the use of a selective serotonin-reuptake inhibitor in an older patient. Age Ageing. 2001;30:94.Google Scholar
22.Bourgeois, JA, Babine, SE, Bahadur, N. A case of SIADH and hyponatremia associated with citalopram. Psychosomatics. 2002;43:241242.Google Scholar