Case Report

A Challenging Case of Syndrome of Inappropriate Secretion of Antidiuretic Hormone in an Elderly Patient Secondary to Quetiapine

Authors: Ayce Atalay, MD, Nur Turhan, MD, Ozlem Erden Aki, MD

Abstract

Hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is an uncommon complication of treatment with centrally acting drugs including selective serotonin reuptake inhibitors (SSRIs) and antipsychotic medications. Antipsychotics are commonly used for the treatment of behavioral and psychiatric symptoms in elderly patients with dementia, and the use of those agents is increasing. Here, we report an elderly man who developed hyponatremia after treatment with medications for depression and agitation.


Key Points


* Antipsychotics are commonly used for the treatment of behavioral and psychologic symptoms in elderly patients with dementia, and the use of those agents is increasing.


* Polypharmacy and concomitant use of another psychotropic drug with a selective serotonin reuptake inhibitor (SSRI) may precipitate and/or augment the development of hyponatremia and/or syndrome of inappropriate secretion of antidiuretic hormone (SIADH).


* The serum sodium concentration in elderly patients who are already on multiple medications should be carefully monitored after the initiation of treatment with an SSRI or an antipsychotic medication.

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