Can mirtazapine cause hyponatremia?

Can mirtazapine cause hyponatremia?

Mirtazapine and tricyclic antidepressants showed a moderate risk of hyponatremia, supporting the use of these drugs as alternative therapy for patients at an increased risk for hyponatremia. Due to insufficient data, the risk associated with MAO inhibitors and bupropion could not be established.

Which antidepressant does not cause hyponatremia?

All antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine.

Why do antidepressants cause hyponatremia?

The mechanism by which SSRIs cause hyponatremia is thought to be secondary to development of SIADH. Treatment of isovolemia hypotonic hyponatremia associated with SSRI use includes water restriction and mild diuresis with a loop diuretic.

Which antidepressant is safe in hyponatremia?

There are case reports supporting that switching from SSRIs to mirtazapine was safe for patients with hyponatremia8,9; however, severe hyponatremia after mirtazapine use has also been reported.

Does bupropion cause hyponatremia?

Bupropion therefore may cause hyponatremia by the noradrenergic stimulation of vasopressin release. Estimates of hyponatremia associated with SSRI and SNRI use vary from 0.5 to 32% [7].

Can omeprazole cause hyponatremia?

We concluded that both omeprazole and pantoprazole caused mild hyponatremia in our patient and considered this to be a PPI class effect.

Will eating more salt help hyponatremia?

In elderly patients with a diet poor in protein and sodium, hyponatremia may be worsened by their low solute intake. The kidney’s need to excrete solutes aids in water excretion. An increase in dietary protein and salt can help improve water excretion.

What medication causes low sodium?

Known offenders include acetazolamide, amiloride, amphotericin, aripiprazole, atovaquone, thiazide diuretics, amiodarone, basiliximab, angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors, bromocriptine, carbamazepine, carboplatin, carvedilol, celecoxib, cyclophosphamide, clofibrate, desmopressin, …

Can Zoloft cause hyponatremia?

To the Editor: Hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone have been reported in patients treated with sertraline (Zoloft).

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How long does it take for SSRI to cause hyponatremia?

The median time to onset of hyponatremia was 13 days (range 3120 days). In all cases the patient’s condition returned to normal 2 to 28 days after discontinua- tion of the SSRI. In 5 of the cases a rechallenge of the medication was reported.

Can antidepressants cause hyponatremia?

Conclusion: Hyponatremia is a potentially dangerous side effect of antidepressants and is not exclusive to SSRIs. Current evidence suggests a relatively higher risk of hyponatremia with SSRIs and venlafaxine, especially when combined with patient risk factors, warranting clinicians to be aware of this complication.

Do all SSRI cause hyponatremia?

Conclusion. There is an increased risk of hyponatremia for all included antidepressants, except for mianserin. The strongest association between hyponatremia and antidepressants is found in SSRIs.

Does gabapentin cause hyponatremia?

Expert opinion: Carbamazepine and oxcarbazepine are the most common AEDs which induce hyponatremia in patients with epilepsy. Recently, other AEDs, such as eslicarbazepine, sodium valproate, lamotrigine, levetiracetam and gabapentin have also been reported to cause hyponatremia.

What causes low sodium in a person?

A low sodium level has many causes, including consumption of too many fluids, kidney failure, heart failure, cirrhosis, and use of diuretics. Symptoms result from brain dysfunction.

Can antidepressants cause electrolyte imbalance?

Taken together with other studies and case reports, the data strongly suggest that SSRIs as a class cause hyponatraemia more frequently than other antidepressant drugs.

Does Wellbutrin raise uric acid levels?

Unlike amitriptyline, bupropion did not increase uric acid or cholesterol levels, and was not associated with weight gain. Bupropion was better tolerated than amitriptyline, the most commonly prescribed antidepressant.

Does Buspar affect sodium levels?

The present study shows that buspirone at doses of 0.25 and 0.5mg/kg eliciting an anxiolytic effect changes the concentration of serum sodium, potassium, calcium, magnesium, plasma osmolality and SBP (fig. 2 and 3 a, b and c).

Does Seroquel cause hyponatremia?

Quetiapine-associated hyponatremia is extremely uncommon and only a few, relevant reports can be found in the literature. This case underlines the fact that patients on antipsychotic medication and more specifically on quetiapine should be closely monitored and routinely tested for electrolyte disorders.

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How quickly can you correct hyponatremia?


Clinical recommendation Evidence rating Comments
In patients with severe symptomatic hyponatremia, the rate of sodium correction should be 6 to 12 mEq per L in the first 24 hours and 18 mEq per L or less in 48 hours. C Consensus guidelines based on systematic reviews

Do all PPIs cause hyponatremia?

Real incidence of PPI-related hyponatremia in the elderly is unknown, but several studies concluded that the chronic use of PPIs increases the risk of hyponatremia and it is thought to be one of the most common causes2.

Can hyponatremia be hereditary?

Hyponatraemia is not itself inherited. However, some conditions with a genetic component can be associated with hyponatraemia.

What are the warning signs of hyponatremia?

Hyponatremia signs and symptoms may include:

  • Nausea and vomiting.
  • Headache.
  • Confusion.
  • Loss of energy, drowsiness and fatigue.
  • Restlessness and irritability.
  • Muscle weakness, spasms or cramps.
  • Seizures.
  • Coma.

What happens if you don’t eat salt for a week?

Higher risk of hyponatremia (low blood levels of sodium) Hyponatremia is a condition characterized by low levels of sodium in the blood. Its symptoms are similar to those caused by dehydration. In severe cases, the brain may swell, which can lead to headaches, seizures, coma, and even death ( 27 ).

How much water should I drink for hyponatremia?

The authors of the study report that hyponatremia symptoms can develop if a person drinks 34 liters of water in a short period, though they do not give a specific time estimate. According to one case report , soldiers developed symptoms after consuming at least 2 quarts (1.9 liters) of water per hour.

Which organ is most affected by hyponatremia?

Hyponatremia occurs when your blood sodium level goes below 135 mEq/L. When the sodium level in your blood is too low, extra water goes into your cells and makes them swell. This swelling can be dangerous especially in the brain, since the brain cannot expand past the skull.

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What is the most common cause of hyponatremia?

Hyponatremia is decrease in serum sodium concentration < 136 mEq/L (< 136 mmol/L) caused by an excess of water relative to solute. Common causes include diuretic use, diarrhea, heart failure, liver disease, renal disease, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Does coffee affect sodium levels?

Chronic caffeine intake increases urinary sodium excretion without affecting plasma sodium concentration.

How do you confirm SIADH?

Euvolaemic hyponatraemia with low serum sodium and osmolality, and raised urine osmolality in the absence of diuretic use or pseudohyponatraemia, are diagnostic of SIADH. Medication use should be reviewed, with consideration of further investigations if there is suspicion of malignancy or neurosurgical conditions.

Is 127 a good sodium level?

Your blood sodium level is normal if it’s 135 to 145 milliequivalents per liter (mEq/L). If it’s below 135 mEq/L, it’s hyponatremia. Your doctor will be able to tell you whether your level is too low.

Can amitriptyline cause hyponatremia?

Some of the older antipsychotic drugs, such as fluphenazine, thiothixene, and phenothiazine, and the tricyclic antidepressants (eg, amitriptyline) can cause hyponatremia with characteristics of SIADH.