Meeting abstract

https://doi.org/10.24869/spsih.2026.226

Hyponatremia as an Adverse Effect of Antidepressants

Anton Vladislović ; Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia *
Tanja Grahovac Juretić ; Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia; Faculty of Medicine in Rijeka, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
Elizabeta Dadić Hero ; Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia; Faculty of Medicine in Rijeka, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
Jelena Rebić ; Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia; Faculty of Medicine in Rijeka, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
Rudolf Ljubičić ; Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
Tomislav Lesica ; Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
Marina Letica Crepulja ; Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia; Faculty of Medicine in Rijeka, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia

* Corresponding author.

Abstract

Hyponatremia caused by antidepressants is a
known and serious adverse effect of medications
from the antidepressant class, especially those
from the SSRI group, such as sertraline and fluoxetine,
and the SNRI group, such as venlafaxine
and duloxetine. It may present with symptoms
such as fatigue and confusion, and in more severe
cases can lead to epileptic seizures. This paper
presents the case of an 89‑year‑old female patient
who developed hyponatremia as an adverse effect
of antidepressant therapy, and outlines the latest
scientific findings on antidepressant‑induced hyponatremia
with the aim of highlighting the importance
of timely recognition and management
of this side effect. The patient was transported
by ambulance from a long‑term psychiatric facility
to the Emergency Department of the Clinical
Hospital Center Rijeka due to a first epileptic
seizure, which manifested as confusion, tremor, and generalized body convulsions without neurological
deficits. Her chronic pharmacotherapy
included venlafaxine, mirtazapine, olanzapine,
pregabalin, and diazepam. Laboratory workup
confirmed hyponatremia with a sodium level of
115 mmol/L, while imaging studies showed normal
findings of the thoracic organs and brain CT,
on which a clinically irrelevant calcified lesion was
observed. The patient was treated with parenteral
diazepam and metoclopramide, along with sodium
replacement using 300 mL of 3% NaCl and
500 mL of 0.9% NaCl. She was evaluated by a
neurologist, internist, and neurosurgeon in a consultative
setting, after which she was admitted
to the Clinic of Neurosurgery. During her stay in
the Clinic, persistently low serum sodium levels
were recorded, and she was therefore referred for
psychiatric consultation. The psychiatrist adjusted
her chronic pharmacotherapy, discontinuing
venlafaxine. Following this adjustment, natremia
stabilized at 140 mmol/L with no further fluctuations,
and there was complete cessation of epileptic
seizures and other symptoms. The patient
was discharged back to her referring hospital with
corrected pharmacotherapy. By presenting this
case, we emphasize the importance of timely recognition
of antidepressant side effects in clinical
practice.

Keywords

iatrogenic hyponatremia; adverse effect; antidepressants; SNRIs; venlafaxine

Hrčak ID:

352373

URI

https://hrcak.srce.hr/352373

Publication date:

15.6.2026.

Article data in other languages: croatian

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