Department of Psychiatry, National Taiwan University Hospital, Taiwan.
Gen Hosp Psychiatry. 2012 Jan-Feb;34(1):101.e5-7. doi: 10.1016/j.genhosppsych.2011.06.007. Epub 2011 Aug 9.
We report the development of hyponatremia following initiation of escitalopram therapy in a 73-year-old woman. The patient, with a history of dementia with Lewy bodies, had presented with multiple neuropsychiatric symptoms. Within 2 months of escitalopram, she became delirious with a serum sodium level of 122 mmol/L. After discontinuation of escitalopram, her consciousness improved with resolving hyponatremia. Delirium and hyponatremia (122 mmol/L), however, recurred after escitalopram was rechallenged. Apart from eight other cases to date, this is the only one with recurrent hyponatremia. Rechallenge of the same antidepressant is discouraged especially in patients at risk of developing hyponatremia.
我们报告了一例 73 岁女性在开始使用依地普仑治疗后出现低钠血症的病例。该患者患有路易体痴呆，有多种神经精神症状。在依地普仑治疗的 2 个月内，她出现了意识混乱，血清钠水平为 122mmol/L。停用依地普仑后，她的意识状态改善，低钠血症也得到了纠正。然而，在再次使用依地普仑后，她又出现了意识混乱和低钠血症（122mmol/L）。除了迄今为止的另外 8 例病例外，这是唯一一例反复发生低钠血症的病例。不鼓励特别是有发生低钠血症风险的患者重复使用相同的抗抑郁药。
