The role of sertraline in a patient with recurrent hyponatremia.

A 75-year-old female with major depression was admitted to the hospital on two separate occasions for medical problems. During both her hospitalizations she was evaluated by a psychiatrist and diagnosed with a major depressive episode. On both admissions the antidepressant chosen to treat her depression was sertraline. Each time the patient was treated with sertraline she developed significant hyponatremia within 7 days of the initiation of therapy. The case is presented and discussed, with special emphasis on the prior reports of hyponatremia associated with sertraline use, and the treatment alternatives.