Department of Internal Medicine, National Health Insurance Kuma-Kogen Town Hospital, Japan.
Health Services Center, Ehime University, Japan.
Intern Med. 2022 Apr 1;61(7):1099-1103. doi: 10.2169/internalmedicine.7722-21. Epub 2021 Sep 11.
Duloxetine is widely used for pain control and depressive syndromes. One of its potential side effects is syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Duloxetine-induced SIADH causes hyponatremia, which leads to a variety of symptoms and has previously been reported in the elderly. In the present case, we experienced a case of the rapid onset of SIADH in a super-elderly woman receiving low-dose duloxetine. Elderly patients tend to have lower duloxetine doses and an earlier onset than non-elderly patients. When hyponatremia occurs after duloxetine administration, duloxetine-induced SIADH should be considered, especially in high-risk elderly patients, regardless of the duloxetine dose or duration of treatment.
度洛西汀被广泛用于疼痛控制和抑郁综合征。其潜在的副作用之一是抗利尿激素分泌不当综合征（SIADH）。度洛西汀引起的 SIADH 导致低钠血症，导致各种症状，此前已有报道见于老年人。在本病例中，我们在接受低剂量度洛西汀治疗的超高龄女性中遇到了一例 SIADH 快速发作的病例。老年患者的度洛西汀剂量往往低于非老年患者，且发病更早。当度洛西汀给药后出现低钠血症时，应考虑度洛西汀引起的 SIADH，尤其是高危老年患者，无论度洛西汀剂量或治疗持续时间如何。
