Miranda M, Armijo G, Miranda P
Unidad de Neurología, Hospital Félix Bulnes, Chile.
Rev Med Chil. 1999 Mar;127(3):337-40.
Serotonin reuptake inhibitors, used as antidepressants, may cause hyponatremia due to a syndrome of inappropriate antidiuretic hormone, specially in elders. Thirty cases with such complication have been reported in the last six years. We report a 76 years old female with a hypertensive cardiopathy and paroxysmal atrial fibrillation treated with amlodipine and sotalol. Five days after starting fluoxetine, the patient presented with a confusional state, gait instability and tremor. Laboratory assessment disclosed a plasma sodium of 115 meq/L. Fluoxetine was discontinued and fluids were restricted. The clinical condition of the patient improved and hyponatremia abated. Hyponatremia must be born in mind as a potential side effect of serotonin reuptake inhibitors.
作为抗抑郁药使用的血清素再摄取抑制剂，可能因抗利尿激素分泌失调综合征而导致低钠血症，尤其在老年人中。在过去六年里已报告了30例出现这种并发症的病例。我们报告了一名76岁患有高血压性心脏病和阵发性心房颤动的女性，她正在接受氨氯地平和索他洛尔治疗。在开始使用氟西汀五天后，患者出现意识模糊状态、步态不稳和震颤。实验室检查显示血浆钠为115毫当量/升。停用氟西汀并限制液体摄入。患者的临床状况得到改善，低钠血症消退。必须记住低钠血症是血清素再摄取抑制剂的一种潜在副作用。
