Hyponatremia due to duloxetine use in an elderly woman patient

Year 2020, , 295 - 298, 01.06.2020

Buket Cinemre Ali Erdoğan , Burak Kulaksızoğlu , Mert Sinan Bingöl

https://doi.org/10.21601/ortadogutipdergisi.762498

Abstract

Hyponatremia is a potentially dangerous side effect of antidepressants. Almost every antidepressant can cause hyponatremia. Duloxetine-induced hyponatremia is a side effect that is usually seen in older women. In addition to advanced age and female sex; low body weight, presence of comorbid diseases are other important risk factors for the development of hyponatremia. In this case report we present a patient with depressive disorder who developed hyponatremia with duloxetine treatment which resolved immediately after the cessation of the medication with supportive electrolyte treatment. In our case, the resolution of hyponatremia with supportive electrolyte treatment in addition to the cessation of duloxetine reminds us about the importance of monitoring sodium levels both before and after antidepressant treatment in geriatric populations.

Keywords

hyponatremia, duloxetine, antidepressant side effect

Yaşlı bir kadın hastada duloksetin kullanımına bağlı hiponatremi

Abstract

Hiponatremi, antidepresanların potansiyel olarak tehlikeli bir yan etkisidir. Hemen hemen her antidepresan hiponatremiye neden olabilir. Duloksetin kaynaklı hiponatremi genellikle yaşlı kadınlarda görülen bir yan etkidir. İleri yaş ve kadın cinsiyetine ek olarak; düşük vücut ağırlığı, komorbid hastalıkların varlığı hiponatremi gelişimi için diğer önemli risk faktörleridir. Bu olgu sunumunda, ilacın kesilmesinden hemen sonra düzelen duloksetin tedavisi ile hiponatremi gelişen depresif bozukluğu olan bir hasta sunulmaktadır. Bizim olgumuzda, duloksetin kesilmesine ek olarak, hiponatreminin destekleyici elektrolit tedavisi ile çözülmesi bize geriatrik popülasyonlarda antidepresan tedavisinden önce ve sonra sodyum seviyelerinin izlenmesinin önemini hatırlatmaktadır.

Keywords

hiponatremi, duloksetin, antidepresan yan etkisi

References

• Muscatello MRA, Zoccali RA, Pandolfo G, Mangano P, Lorusso S, Cedro C, et al. Duloxetine in Psychiatric Disorders: Expansions Beyond Major Depression and Generalized Anxiety Disorder. Front Psychiatry. 2019; 10: 772. (doi: 10.3389/fpsyt.2019.00772).
• Hoorn, EJ, Lindemans J, Zietse R. Development of severe hyponatraemia in hospitalized patients: treatment-related risk factors and inadequate management. Nephrol Dial Transplant. 2006; 21(1): 70-6. (doi: 10.1093/ndt/gfi082).
• Peri A, Giuliani C. Management of euvolemic hyponatremia attributed to SIADH in the hospital setting. Minerva Endocrinol. 2014; 39(1): 33‐41.
• De Picker L, Van Den Eede F, Dumont G, Moorkens G, Sabbe BG. Antidepressants and the risk of hyponatremia: a class-by-class review of literature. Psychosomatics 2014; 55(6): 536-47. (doi: 10.1016/j.psym.2014.01.010).
• Liu BA, Mittmann N, Knowles SR, Shear NH. Hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone associated with the use of selective serotonin reuptake inhibitors: a review of spontaneous reports. [published correction appears in Can Med Assoc J 1996 Oct 15; 155(8): 1043]. CMAJ. 1996; 155(5): 519-27.
• Viramontes TS, Truong H, Linnebur SA. Antidepressant-Induced Hyponatremia in Older Adults. Consult Pharm. 2016; 31(3): 139‐50. (doi: 10.4140/TCP.n.2016.139).
• Safdieh JE, Rudominer R. A case of hyponatremia induced by duloxetine. J Clin Psychopharmacol. 2006; 26(6): 675-6. (doi: 10.1097/01.jcp.0000246207.73034.96).
• Sun CF, Chen YL, Li YH, Kumaraswamy M, Lo YC, Chen YT. Duloxetine-Induced Hyponatremia in an Elderly Male Patient with Treatment-Refractory Major Depressive Disorder. Case Rep Psychiatry. 2019; 2019: 4109150. (doi: 10.1155/2019/4109150).
• Sahan E, Yıldız FBP. Duloxetine Induced Hyponatremia. Turk Psikiyatri Derg. 2019; 30(4). (doi: 10.5080/u23394).
• Yoshida K, Aburakawa Y, Suzuki Y, Kuroda K, Kimura T. Acute Hyponatremia Resulting from Duloxetine-induced Syndrome of Inappropriate Antidiuretic Hormone Secretion. Intern Med. 2019; 58(13): 1939‐42. (doi: 10.2169/internalmedicine.2346-18).
• Takayama A, Nagamine T, Matsumoto Y, Nakamura M. Duloxetine and Angiotensin II Receptor Blocker Combination Potentially Induce Severe Hyponatremia in an Elderly Woman. Intern Med. 2019; 58(12): 1791‐4. (doi: 10.2169/internalmedicine.2059-18).
• Hu D, Wurster S. Hyponatremia Induced by Duloxetine: A Case Report. Consult Pharm. 2018; 33(8): 446-9. (doi: 10.4140/TCP.n.2018.446).