Combination of Diuretics and SSRIs Leading Severe Hyponatremia: A Case Report

Bora E, Omeroglu A, Polat ZP, Kara O, Akdogan F and Basat SU

Department of Internal Medicine, Umraniye Education and Research Hospital, Turkey

^*Correspondance to: Zeynep Pelin Polat 

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Abstract:

Hyponatremia is one of the most encountered electrolyte imbalances among all medical fields. It has a wide range of symptoms as well as complications from fatigue to loss of consciousness. Although a lot of factors can cause low sodium levels, combining specific medications can lead severe hyponatremia in a rapid onset which can cause high mortality and morbidity. The objective of this case report was to underline that prescribing specific medications disregarding their side effects can cause this common electrolyte imbalance but in a more severe manner. In this case report, we present a 46-year-old male patient with serum sodium level of 104 mEq/L who consumed hydrochlorothiazide for hypertension and was under treatment with Selective Serotonin Reuptake Inhibitors (SSRIs) for major depression. Patient had tonic-clonic seizures at the second hour of the treatment and intubation was needed due to loss of consciousness and hypoxia. After proper replacement of sodium with hypertonic solutions in intensive care unit for nine days, extubation was indicated. Even in healthy young males, hyponatremia due to two separately prescribed medications can lead life threatening hyponatremia. Physicians should be aware of the side effects of diuretics, especially hydrochlorothiazides and SSRIs and their combinations.

Keywords:

Diuretics; Hydrochlorotiazide; Hyponatremia, SSRI

Cite the Article:

Bora E, Omeroglu A, Polat ZP, Kara O, Akdogan F, Basat SU. Combination of Diuretics and SSRIs Leading Severe Hyponatremia: A Case Report. Clin Case Rep Int. 2019; 3: 1096.