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Comment in:
Incidence and risk
factors for hyponatraemia following treatment with fluoxetine or
paroxetine in elderly people.
Wilkinson TJ, Begg
EJ, Winter AC, Sainsbury R.
Department of Health Care of the
Elderly, Princess Margaret Hospital, Christchurch, New
Zealand.
AIMS: To establish the incidence, time course and risk
factors of hyponatraemia complicating treatment with fluoxetine or
paroxetine in an elderly population. METHODS: Retrospective descriptive
and case control study in an inpatient/outpatient assessment and
rehabilitation service for people aged 65 years and over. Fourteen
elderly patients with hyponatraemia complicating treatment with
fluoxetine or paroxetine, matched with 56 controls drawn from 845
patients treated with fluoxetine or paroxetine over 3.5 years. No other
SSRI antidepressants were used over the study period. RESULTS: The
incidence of hyponatraemia was 4.7/1000 people treated/year (6.3/1000
for fluoxetine and 3.5/1000 for paroxetine). Hyponatraemia was detected
at a median 13.5 (mean 18.6, range 4-64) days after commencing the drug.
Mean (95% confidence intervals) body weights were lower in cases at 53.0
(95% CI 46.5-59.5) kg compared with controls at 64.5 (95% CI 60.1-68.4)
kg (P<0.01). 71% of cases were women compared with 45% of controls
(P=0.07) but the effect of gender was confounded by body weight. There
were trends for cases to be older (odds ratio 1.10: 95% CI 0.99, 1.23)
and lighter (odds ratio 0.92, 95% CI 0.86, 0.99). CONCLUSIONS:
Approximately 1 in 200 elderly people treated per year with fluoxetine
or paroxetine developed complicating hyponatraemia. Low body weight was
a particular risk factor. Most cases occurred within 3 weeks of
treatment.
PMID: 10190657 [PubMed - indexed for MEDLINE]
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