Bigaillon C, El Jahiri Y, Garcia C, Hejl-Garcia C, Mayaudon H, Ceppa F, Burnat P
Laboratoire de biochimie, hôpital d'instruction des Armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
Rev Med Interne. 2007 Sep;28(9):642-4. doi: 10.1016/j.revmed.2007.03.336. Epub 2007 Apr 25.
Selective serotonin reuptake inhibitors (SSRI) are the most common antidepressants prescribed for elderly people. Although they are generally better tolerated than other antidepressant treatment classes, they can be responsible for potentially life-threatening hyponatremia, related to syndrome of inappropriate antidiuretic hormone secretion (SIADH).
A 64 years-old woman was hospitalized for cognitive function alteration and vomiting after introduction of paroxetine for depressive symptoms. Serum investigations revealed hyponatremia (121 mmol/l) with low plasma osmolarity and normal natriuria consistent with diagnosis of SIADH. Hyponatremia was reversible after paroxetine withdrawal.
Hyponatremia induced by SIADH is a serious but underestimated complication of SSRI treatment. This complication occurs in the elderly people within the first month of treatment. Monitoring of the serum sodium concentration during the first month of treatment is recommended for older patients.
选择性5-羟色胺再摄取抑制剂（SSRI）是为老年人开具的最常见的抗抑郁药。尽管它们通常比其他抗抑郁治疗类别耐受性更好，但它们可能导致与抗利尿激素分泌不当综合征（SIADH）相关的潜在危及生命的低钠血症。
一名64岁女性在因抑郁症状服用帕罗西汀后因认知功能改变和呕吐住院。血清检查显示低钠血症（121 mmol/L），血浆渗透压降低，尿钠正常，符合SIADH的诊断。停用帕罗西汀后低钠血症可逆。
SIADH引起 的低钠血症是SSRI治疗的一种严重但被低估的并发症。这种并发症在治疗的第一个月内发生在老年人中。建议对老年患者在治疗的第一个月内监测血清钠浓度
