艾司西酞普兰所致慢性低血容量性低钠血症

IF 0.8 Q4 PHARMACOLOGY & PHARMACY
J. Prakash, M. Abhirami, Navya Sri G, V. Dalal, A. Swamy, Kurian Thomas
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引用次数: 0

摘要

选择性5 -羟色胺再摄取抑制剂(SSRIs),近年来在一系列情绪障碍的处方中有所增加,特别是在老年人群中。尽管SSRIs是一种耐受性良好的抗抑郁药,但它与低钠血症有关,这是一种罕见但致命的副作用,在文献中发病率在0.5%-32%之间。低血容量性低钠血症最常与抗利尿激素分泌不当综合征相关。我们进行了广泛的文献回顾,共发现20例艾司西酞普兰被报道为低钠血症的病原体。我们报告一例82岁的女性患者,因其丈夫去世,有急性起病、进行性记忆障碍和行为改变伴抑郁认知的病史,给予艾司西酞普兰5mg /d和氯硝西泮0.5 mg/d治疗。她以步态不平衡、颤抖、易怒、精神错乱、语言输出减少和受迫害妄想等主诉入院。她被诊断为迟发性器质性精神病,艾司西酞普兰引起的慢性不受控制的低钠血症沉淀并加重,钠水平为115 mmol/L。停用艾司西酞普兰后,患者血清钠水平逐渐改善,意识逐渐好转。这是迄今为止文献中报道的第二例复发性低钠血症,另一例由Tsai等人于2012年报道。此外,艾司西酞普兰的剂量仅为5mg /天,而其他报告病例的剂量范围在10 - 20mg /天之间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Escitalopram-Induced Chronic Euvolemic Hyponatremia
Selective serotonin reuptake inhibitors (SSRIs), through the recent years have seen an increase in the number of prescriptions for a spectrum of mood disorders, especially in the geriatric population. Despite being a well-tolerated antidepressant, SSRIs have been associated with hyponatremia, a rare, but fatal adverse effect and the incidence ranges from 0.5%–32% in literature. Euvolemic hyponatremia is most commonly associated with syndrome of inappropriate secretion of antidiuretic hormone. An extensive review of literature was carried out, and we came across a total of 20 cases where escitalopram was reported as the causative agent of hyponatremia. We report a case of an 82-year-old female patient who had a history of acute onset, progressive memory impairment, and behavioral changes with depressive cognition precipitated by the death of her husband, for which she was treated with escitalopram 5 mg/day and clonazepam 0.5 mg/day. She was admitted to the hospital with presenting complaints of gait imbalance, tremors, irritability, confusion, decreased speech output and persecutory delusions. She was diagnosed with late-onset organic psychosis, precipitated and worsened by escitalopram-induced chronic uncontrolled euvolemic hyponatremia, with a sodium level of 115 mmol/L. On discontinuation of escitalopram, the patient's serum sodium level improved gradually, and her consciousness became better. This is the second case with recurrent hyponatremia in the literature up to this date, with the other being reported by Tsai et al., in 2012. Furthermore, the dose of escitalopram was only 5 mg/day compared to other reported cases where the dose ranged between 10–20 mg/day.
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
37
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