The relationship between psychotropic drugs and hyponatremia: a review

Yıl 2020, Cilt: 1 Sayı: 3, 71 - 75, 21.09.2020

Mehmet Hamdi Örüm

https://doi.org/10.47582/jompac.725340

Öz

Hyponatremia is the most frequently reported electrolyte disturbance following the use of psychotropic drugs. It is well known that antidepressants, antipsychotics and mood stabilizers used in the treatment of psychiatric disorders carry a risk of hyponatremia. Although creating hyponatremia without any risk factors, there are some risk factors associated with this side effect of psychotropic drugs: advanced age, concomitant non-psychiatric drug use, and the presence of medical comorbidities. As a psychotropic drug side effect, hyponatremia can have various consequences ranging from confusion and agitation to death. Hyponatremia related to psychotropic drugs is associated with syndrome of inappropriate antidiuretic hormone secretion, which is a cause of euvolemic hyponatremia. Clinicians should consider the possibility of psychogenic polydipsia and drug interactions, as well as psychotropic drug-induced hyponatremia. Early diagnosis and treatment of hyponatremia due to psychotropic drugs, which can be potentially fatal, is important.

Anahtar Kelimeler

Psychotropic drugs, hyponatremia, antidepressive agents, antipsychotic agents

Psikotropik ilaçlar ve hiponatremi ilişkisi: bir derleme

Öz

Hiponatremi, psikotropik ilaçların kullanımını takiben en sık bildirilen elektrolit bozukluğudur. Psikiyatrik bozuklukların tedavisinde kullanılan antidepresan, antipsikotik ve duygudurum düzenleyicilerinin hiponatremi riski taşıdığı iyi bilinmektedir. Herhangi bir risk faktörü olmadan da hiponatremi oluşturmakla birlikte psikotropik ilaçların bu yan etkisiyle ilişkili olan bazı risk faktörleri bulunmaktadır: İleri yaş, eşzamanlı psikiyatrik olmayan ilaç kullanımı ve tıbbi komorbiditelerin varlığı. Bir psikotropik ilaç yan etkisi olarak hiponatremi, konfüzyon ve ajitasyondan ölüme kadar giden çeşitli sonuçlar doğurabilir. Psikotropik ilaçlara bağlı hiponatremi bir övolemik hiponatremi nedeni olan uygunsuz antidiüretik hormon salınımı sendromu ile ilişkilendirilmektedir. Klinisyenler psikotropik ilaca bağlı hiponatreminin yanında psikojenik polidipsi olasılığını ve ilaç etkileşimlerini dikkate almalıdır. Potansiyel olarak ölümcül olabilen psikotropik ilaçlara bağlı hiponatreminin erken tanısı ve tedavisi önemlidir.

Anahtar Kelimeler

Psikotropik ilaçlar, hiponatremi, antidepresif ajanlar, antipsikotik ajanlar

Kaynakça

• Hoorn EJ, Zietse R. Diagnosis and treatment of hyponatremia: compilation of the guidelines. J Am Soc Nephrol 2017; 28: 1340-9.
• 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: 70-6.
• Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med 2000; 342: 1581-9.
• Henry DA. In the clinic: hyponatremia. Ann Intern Med 2015; 163: ITC1-19.
• Buffington MA, Abreo K. Hyponatremia: a review. J Intensive Care Med 2016; 31: 223-36.
• Dresely F. Distrubances of sodium homeostasis. Anasthesiol Intensivmed Notfallmed Schmerzther 2018; 53: 492-502.
• Jones DP. Syndrome of inappropriate secretion of antidiüretic hormone and hyponatremia. Pediatr Rev 2018; 39: 27-35.
• Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 1967; 42: 790-806.
• Ball SG, Iqbal Z. Diagnosis and treatment of hyponatraemia. Best Pract Res Clin Endocrinol Metab 2016; 30: 161-73.
• Dineen R, Thompson CJ, Sherlock M. Hyponatraemia – presentations and management. Clin Med (Lond) 2017; 17: 263-9.
• Orum MH, Kalenderoglu A, Egilmez OB, Ozen ME, Kapici Y. Hyponatremia associated with repeated use of sodium valproate. Psychiatry Behav Sci 2018; 8: 93-4.
• Spigset O, Hedenmalm K. Hyponatraemia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by psychotropic drugs. Drug Saf 1995; 12: 209-25.
• de Leon J, Verghese C, Tracy JI, Josiassen RC, Simpson GM. Polydipsia and water intoxication in psychiatric patients: a review of the epidemiological literature. Biol Psychiatry 1994; 35: 408-19.
• Örüm MH, Han Almış B. Hyponatremia during treatment with the clozapine-amisulpride combination: a suspected association and improvement with dose reduction. Dusunen Adam J Psychiatr Neurol Sci 2019; 32: 171-4.
• Örüm MH, Eğilmez OB. Compulsive water drinking resulting in hyponatremia: a pimozide case. Med Records 2019; 1: 48-9.
• Örüm MH. Sodium valproate use may result in hyponatremia. J Health Sci Med 2020; 3: 193-5.
• Luzecky MH, Burman KD, Schultz ER. The syndrome of inappropriate secretion of antidiuretic hormone associated with amitriptyline administration. South Med J 1974; 67: 495-7.
• Özen ME, Örüm MH, Kalenderoğlu A. Escitalopram-induced hyponatremia: a case report. Psychiatry Psychopharmacol 2018; 28: 211.
• Fabian TJ, Amico JA, Kroboth PD, et al. Paroxetine induced hyponatremia in older adults: a 12-week prospective study. Arch Intern Med 2004; 164: 327-32.
• Farmand S, Lindh J, Calissendorff J, et al. Differences in associations of antidepressants and hospitalization due to hyponatremia. Am J Med 2018; 131: 56-63.
• Lien YH. Antidepressants and hyponatremia. Am J Med 2018; 131: 7-8.
• Siafis S, Tzachanis D, Samara M, Papazisis G. Antipsychotic drugs: from receptor-binding profiles to metabolic side effects. Curr Neuropharmacol 2018; 16: 1210-23.
• Falhammar H, Lindh JD, Calissendorff J, Skov J, Nathanson D, Mannheimer B. Antipsychotics and severe hyponatremia: a Swedish population-based case-control study. Eur J Intern Med 2019; 60: 71-7.
• Gandhi S, McArthur E, Reiss JP, et al. Atypical antipsychotic medications and hyponatremia in older adults: a population-based cohort study. Can J Kidney Health Dis 2016; 3: 21.
• Lu X, Wang X. Hyponatremia induced by antiepileptic drugs in patients with epilepsy. Expert Opin Drug Saf 2017; 16: 77-87.
• Kinzie BJ. Management of the syndrome of inappropriate secretion of antidiuretic hormone. Clin Pharm 1987; 6: 625-33.