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Tricyclics as a possible cause of hyponatremia in psychiatric patients

Tricyclics as a possible cause of hyponatremia in psychiatric patients lead to impaired thiamine absorption. Patients with bipolar disorder, who constitute the major target population treated with lithium, have been noted to have a high incidence of alcohol abuse, a key etiotogical factor in Wernicke’s enceph-stniction. Her hyponatremia was corrected over a period of 2 days. Hen mental status returned to baseline as the hyponatremia resolved. She was discharged after 1 week with a serum sodium level of 138 meq/liter and mentalalopathy.In addition,be givento lith-ium’s having a direct inhibitory effect on the action of thiamine as a coenzyme, possibly through its ability to alter calcium-dependent processes (2) or through interference with the action of thiamine phosphatases in thiamine phosphorytation (3). There are a number of reports describingstatus at baseline level. Over the subsequent I 8 months take nortniptyline without furtherwithout recurrence of hyponatnemiathe patientdiuretic fromstate.titer.or confusional 133 to 136meq/of this effectuse, but no de(4, 5).While it is presumably a relatively rare case illustrates the potential for tnicyclic induce SIADH (2). In this case the effectsphenomenon, antidepressants on serumthis to sodium sodium treated of hy-REFERENCES 1. Reuler JB, Girard DE, Cooney TC: Current concepts of Wernicke’s encephalopathy. N EngI J Med 1985; 312:1035-1039 2. Mettzer HL: Lithium mechanisms in http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Psychiatry American Psychiatric Publishing, Inc (Journal)

Tricyclics as a possible cause of hyponatremia in psychiatric patients

American Journal of Psychiatry , Volume 146 (6) – Jun 1, 1989

Tricyclics as a possible cause of hyponatremia in psychiatric patients

American Journal of Psychiatry , Volume 146 (6) – Jun 1, 1989

Abstract

lead to impaired thiamine absorption. Patients with bipolar disorder, who constitute the major target population treated with lithium, have been noted to have a high incidence of alcohol abuse, a key etiotogical factor in Wernicke’s enceph-stniction. Her hyponatremia was corrected over a period of 2 days. Hen mental status returned to baseline as the hyponatremia resolved. She was discharged after 1 week with a serum sodium level of 138 meq/liter and mentalalopathy.In addition,be givento lith-ium’s having a direct inhibitory effect on the action of thiamine as a coenzyme, possibly through its ability to alter calcium-dependent processes (2) or through interference with the action of thiamine phosphatases in thiamine phosphorytation (3). There are a number of reports describingstatus at baseline level. Over the subsequent I 8 months take nortniptyline without furtherwithout recurrence of hyponatnemiathe patientdiuretic fromstate.titer.or confusional 133 to 136meq/of this effectuse, but no de(4, 5).While it is presumably a relatively rare case illustrates the potential for tnicyclic induce SIADH (2). In this case the effectsphenomenon, antidepressants on serumthis to sodium sodium treated of hy-REFERENCES 1. Reuler JB, Girard DE, Cooney TC: Current concepts of Wernicke’s encephalopathy. N EngI J Med 1985; 312:1035-1039 2. Mettzer HL: Lithium mechanisms in

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Publisher
American Psychiatric Publishing, Inc (Journal)
Copyright
Copyright © American Psychiatric Association. All rights reserved
ISSN
0002-953X
Publisher site
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Abstract

lead to impaired thiamine absorption. Patients with bipolar disorder, who constitute the major target population treated with lithium, have been noted to have a high incidence of alcohol abuse, a key etiotogical factor in Wernicke’s enceph-stniction. Her hyponatremia was corrected over a period of 2 days. Hen mental status returned to baseline as the hyponatremia resolved. She was discharged after 1 week with a serum sodium level of 138 meq/liter and mentalalopathy.In addition,be givento lith-ium’s having a direct inhibitory effect on the action of thiamine as a coenzyme, possibly through its ability to alter calcium-dependent processes (2) or through interference with the action of thiamine phosphatases in thiamine phosphorytation (3). There are a number of reports describingstatus at baseline level. Over the subsequent I 8 months take nortniptyline without furtherwithout recurrence of hyponatnemiathe patientdiuretic fromstate.titer.or confusional 133 to 136meq/of this effectuse, but no de(4, 5).While it is presumably a relatively rare case illustrates the potential for tnicyclic induce SIADH (2). In this case the effectsphenomenon, antidepressants on serumthis to sodium sodium treated of hy-REFERENCES 1. Reuler JB, Girard DE, Cooney TC: Current concepts of Wernicke’s encephalopathy. N EngI J Med 1985; 312:1035-1039 2. Mettzer HL: Lithium mechanisms in

Journal

American Journal of PsychiatryAmerican Psychiatric Publishing, Inc (Journal)

Published: Jun 1, 1989

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