Citalopram-Induced Severe Hyponatraemia with Coma and Seizure
- PDF / 140,308 Bytes
- 9 Pages / 504 x 720 pts Page_size
- 38 Downloads / 190 Views
Adv Drug React Toxicol Rev 2002; 21 (4): 179-187 0964-198X/02/0004-0179/$25.00/0 © Adis International Limited. All rights reserved.
Citalopram–Induced Severe Hyponatraemia with Coma and Seizure Case Report with Literature and Spontaneous Reports Review Alexander Fisher,1 Michael Davis,1,2 James Croft-Baker,1 Patrick Purcell3 and Allan McLean1,4 1 2 3 4
Department of Geriatric Medicine, The Canberra Hospital, Woden, Canberra, ACT, Australia The Canberra Clinical School of the University of Sydney, Canberra, ACT, Australia Therapeutic Goods Administration, Canberra, ACT, Australia National Ageing Research Institute and Melbourne Health, Parkville, Victoria, Australia
Contents Abstract . . . . . . . . . . . . . . . . . . . . 1. Case Report . . . . . . . . . . . . . . . . . . . 2. Published Reports . . . . . . . . . . . . . . . 3. Australian Reports . . . . . . . . . . . . . . . 4. Discussion . . . . . . . . . . . . . . . . . . . . 4.1 Clinical Characteristics and Risk Factors 5. Rechallenge . . . . . . . . . . . . . . . . . . 6. Mechanisms . . . . . . . . . . . . . . . . . . . 7. Conclusions . . . . . . . . . . . . . . . . . . .
Abstract
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
179 180 181 182 182 183 184 184 185
Numerous case reports of hyponatraemia followed increasing use of selective serotonin re-uptake inhibitors (SSRIs) but this adverse effect was only rarely observed in relation to citalopram. We report a case of severe hyponatraemia associated with deep coma, seizure, atrial fibrillation and muscle damage in a 92-year-old woman after only two doses of citalopram, and review 14 cases previously published in the literature and 28 cases spontaneously reported to Australian Drug Reaction Advisory Committee (ADRAC). The data presented suggest that citalopram, as well as SSRIs may cause hyponatraemia secondary to syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The majority of symptomatic cases occurred in elderly patients (79% were older than 70 years) and in women (74%). Polymedication and concomitant use of another psychotropic drug or thiazide diuretic may precipitate and/or augment the development of hyponatraemia/SIADH. In 84% of cases, the hyponatraemia associated with citalopram was detected during the first month of treatment. High level of suspicion, close and careful monitoring of serum sodium concentration particularly in elderly patients and especially in the first month of therapy with citalopram may reduce the incidence of this serious an
Data Loading...
