Which of the following is least likely to cause hyponatraemia?
Exam Question Jul 2014
Most antidepressants are linked with hyponatraemia. There are notably fewer reports for MAOIs and none for agomelatine (Maudsley Guidelines 11th Edition)
Exam Question Jul 2014
Most antidepressants are linked with hyponatraemia. There are notably fewer reports for MAOIs and none for agomelatine (Maudsley Guidelines 11th Edition)
Antidepressants (hyponatremia)
Hyponatremia is associated with antidepressant use (particularly in the elderly). Unexplained symptoms such as confusion or lethargy, particularly in the first few weeks of therapy should prompt measurement of serum sodium. Most reports suggest that hyponatremia recurs upon rechallenge, even if a different antidepressant is prescribed.
Most antidepressants have a reported association with hyponatremia. It is suggested that SSRIs are relatively more likely to cause it.
For those who develop hyponatremia with an SSRI ideally prescribe a drug from a different class. Consider noradrenergic drugs such as nortriptyline and lofepramine or an MAOI such as moclobemide (Maudsley Guidelines 11th Edition)
Antipsychotics along with other antidepressants have also been associated with hyponatremia (see below).
Non-SSRI antidepressants associated with hyponatremia:-
- Imipramine
- Amitriptyline
- Clomipramine
- Desipramine
- Lofepramine
- Amoxapine
- Doxepin
- Dothiepin
- Trazodone
- Viloxazine
- Phenelzine
- Tranylcypromine
- Venlafaxine
Antipsychotics associated with hyponatremia:-
- Chlorpromazine
- Fluphenazine
- Trifluoperazine
- Thioridazine
- Thiothixene
- Haloperidol
- Clozapine
Hyponatremia Associated With Selective Serotonin Reuptake Inhibitors. Consult Pharm 2000;15:160-77.
