Hyponatriëmie bij gebruik van selectieve serotonineheropnameremmers: meldingen in 1992-2002

To describe the reports of serotonin re-uptake inhibitor (SSRI)-induced hyponatraemia that were sent to the Netherlands Pharmacovigilance Centre Lareb and the Inspectorate for Health Care.

Design

Descriptive study.

Method

Reports of SSRI-induced hyponatraemia received by Lareb and the Inspectorate for Health Care during the period 1 January 1992 to 1 July 2002 were described on the basis of symptoms, co-medication and comorbidity.

Results

A total of 42 cases were reported, 38 (90) of which concerned women and 21 (50) of which concerned the concomitant use of SSRIs and diuretics. The mean age was 74 years (range: 30-91). The mean serum sodium concentration was 115 mmol/l (range: 97-132). The most important symptoms were reduced consciousness, confusion, falls, nausea and vomiting. 3 patients (7) died in the period of the reported adverse drug reaction and 27 patients (64) were hospitalised, of which 4 (10) to the intensive care unit.

Conclusion

These reports of suspected SSRI-induced hyponatraemia were attended with significant morbidity and substantial mortality. The considerable morbidity and substantial mortality in combination with the increasing use of SSRIs necessitates a clarification of the actual incidence and severity of SSRI-induced hyponatraemia.