Evaluation of hyponatremia among older adults exposed to selective serotonin reuptake inhibitors and thiazide diuretics.

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-03-04 DOI:10.1002/phar.70004
Trisha Matsuura, Abdelrahaman G Tawfik, Kenechukwu C Ben-Umeh, Philip D Hansten, Daniel C Malone
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Abstract

Objective: Hyponatremia is a common electrolyte disorder among older adults that can cause serious adverse effects. The purpose of this study was to assess the risk of hyponatremia with the concurrent use of selective serotonin reuptake inhibitors (SSRIs) and thiazide diuretics in an older population.

Methods: Two retrospective nested case-control studies were conducted with exposure to an SSRI or a thiazide diuretic. Persons of interest were those enrolled in Medicare and who received parts A, B, and D benefits from 2017 to 2019 and who were receiving either an SSRI or thiazide diuretic. Cases were individuals with a diagnosis of hyponatremia. Controls had no documented history of hyponatremia. A logistic regression was conducted to determine the odds of hyponatremia.

Results: Of the 551,298 patients receiving a SSRIs, the mean age was 77.8 years (Standard Deviation (SD) ± 8.0 years), 69% were female, and 91.23% were classified as White. We identified 701,007 individuals receiving a thiazide diuretic, with a mean age of 77.1 years (SD ± 7.2 years), 60.2% female, and 82.72% White. The prevalence of hyponatremia was 10.4% in patients taking thiazides alone and 9.0% in those taking SSRIs alone. On the other hand, patients on both medications had a hyponatremia prevalence of approximately 13.0%. Among SSRI users, the adjusted odds ratio (OR) of hyponatremia with concomitant use of thiazide diuretics was 1.24 (95% Confidence Interval (CI): 1.22-1.26). For thiazide users, the adjusted OR of hyponatremia with exposure to SSRIs was 1.27 (95% CI:1.24-1.29).

Conclusion: The concurrent use of thiazide diuretics and SSRIs is associated with an increased risk of hyponatremia in older populations.

暴露于选择性血清素再摄取抑制剂和噻嗪类利尿剂的老年人低钠血症的评估。
目的:低钠血症是老年人常见的电解质紊乱,可引起严重的不良反应。本研究的目的是评估老年人群同时使用选择性5 -羟色胺再摄取抑制剂(SSRIs)和噻嗪类利尿剂的低钠血症风险。方法:对暴露于SSRI或噻嗪类利尿剂的患者进行两项回顾性巢式病例对照研究。感兴趣的人是在2017年至2019年期间参加医疗保险并获得A、B和D部分福利的人,他们正在接受SSRI或噻嗪类利尿剂。病例是诊断为低钠血症的个体。对照组无低钠血症病史。进行逻辑回归以确定低钠血症的几率。结果:551,298例接受SSRIs治疗的患者中,平均年龄为77.8岁(标准差(SD)±8.0岁),女性占69%,白人占91.23%。我们确定了701,007例接受噻嗪类利尿剂的患者,平均年龄为77.1岁(SD±7.2岁),60.2%为女性,82.72%为白人。单独服用噻嗪类药物的低钠血症发生率为10.4%,单独服用SSRIs的低钠血症发生率为9.0%。另一方面,服用两种药物的患者低钠血症患病率约为13.0%。在SSRI服用者中,低钠血症合并噻嗪类利尿剂的校正优势比(OR)为1.24(95%可信区间(CI): 1.22-1.26)。对于噻嗪类药物使用者,低钠血症与SSRIs暴露的调整比值比为1.27 (95% CI:1.24-1.29)。结论:老年人群同时使用噻嗪类利尿剂和SSRIs与低钠血症风险增加相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pharmacotherapy
Pharmacotherapy 医学-药学
CiteScore
7.80
自引率
2.40%
发文量
93
审稿时长
4-8 weeks
期刊介绍: Pharmacotherapy is devoted to publication of original research articles on all aspects of human pharmacology and review articles on drugs and drug therapy. The Editors and Editorial Board invite original research reports on pharmacokinetic, bioavailability, and drug interaction studies, clinical trials, investigations of specific pharmacological properties of drugs, and related topics.
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