Reactions 1680, p91 - 2 Dec 2017 X S Syndrome of inappropriate secretion of antidiuretic hormone and hyponatraemia: case report A 67-year-old man developed syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and hyponatraemia following a concomitant administration of citalopram and omeprazole [routes and durations of treatments to reactions onsets not stated]. The man, who had a history of anxiety and gastrooesophageal reflux disease, started receiving treatment with citalopram 10mg and omeprazole 20mg daily, respectively on 02 March 2016. Concomitantly, he was also receiving hydrochlorothiazide and lisinopril. In March, he visited emergency department (ED) for several times. No organic aetiology was noted and he was prescribed alprazolam for anxiety. He presented to the ED several times in May with a complaints of anxiety, abdominal pain, insomnia and racing heart. On 15 April 2016, his citalopram dose was titrated to 15mg daily and omeprazole to 20mg twice daily. On 14 April 2016, he appeared anxious and complained of mental fog, lethargic feeling, loss of appetite and dizziness. A review of the laboratory tests revealed a gradual decline of serum sodium levels. The man’s citalopram dose was decreased to 5mg thrice daily. On 23 June 2016, a repeat sodium test showed sodium level at 133 [unit not stated]. An improvement was noted and he felt calmer with clear mentation. A diagnosis of medication- induced SIADH was made. Metabolism of citalopram and omeprazole occurs through CYP2C19 and omeprazole is known to decrease the hepatic metabolism of citalopram, confirming the role of both drugs in SIADH. Author comment: "Older patients and certain medications, such as SSRIs and omeprazole, have been implicated in development of SIADH." "Both citalopram and omeprazole are metabolized through CYP2C19, and omeprazole has been implicated in decreasing hepatic metabolism of citalopram." Lamba P. Anxiety to confusion: CYP interaction to SIADH. CNS Spectrums 22: 92 abstr. 155, No. 1, Feb 2017. Available from: URL: http://doi.org/10.1017/ S1092852916000900 [abstract] - USA 803284841 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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