Bozzolo M, Noll G, Lüscher T F
Departement Innere Medizin, Universitätskliniken, Kantonsspital Basel.
Schweiz Rundsch Med Prax. 1992 Nov 17;81(47):1435-8.
The syndrome of inadequate secretion of antidiuretic hormone (SIADH) following treatment with a tricyclic antidepressant is demonstrated using the example of a 70 year-old man admitted for weakness and cognitive disturbances. Because of incontinence he had been periodically treated since 1989 with imipramine (Tofranil) by his family doctor. On admission he was seriously hyponatriemic and had low plasmatic osmolality, significantly lower than urinary osmolality. Creatinine, urea and uric acid in serum were also below normal values. Like other drugs tricyclic antidepressants can rarely induce an increased release of ADH by direct hypothalamic stimuli. In this patient imipramine was terminated and within a few days of reduced fluid intake and substitution of sodium a sustained clinical improvement and normalisation of laboratory parameters was noted. The patient was discharged to his home after three weeks.
以一名因虚弱和认知障碍入院的70岁男性为例，证明了三环类抗抑郁药治疗后抗利尿激素分泌不足综合征（SIADH）。自1989年起，由于尿失禁，他的家庭医生定期给他使用丙咪嗪（托弗尼尔）进行治疗。入院时，他严重低钠血症，血浆渗透压降低，明显低于尿渗透压。血清中的肌酐、尿素和尿酸也低于正常值。与其他药物一样，三环类抗抑郁药很少能通过直接的下丘脑刺激诱导抗利尿激素释放增加。在该患者中，停用了丙咪嗪，在减少液体摄入并补充钠后的几天内，临床症状持续改善，实验室参数恢复正常。三周后患者出院回家。
