Reactions 1404 - 2 Jun 2012

SCitalopram

Syndrome of inappropriate antidiuretic hormonesecretion treated with tolvaptan in an elderlypatient: case report

A 72-year-old man developed syndrome of inappropriateantidiuretic hormone secretion (SIADH) while receivingcitalopram for depressive syndrome; he was successfullytreated with tolvaptan.

The man presented due to a fall followed by a convulsiveepisode with tonic-clonic seizures lasting 10 minutes. Hisfamily reported that he had been unstable when walking,irritable, disorientated and emotionally labile during thelast 15 days. He had a history of frontal dementia, anddepressive syndrome in the third week of treatment withcitalopram [dosage and route not stated]. Based on sodiumlevels, and plasma and urine osmolarity findings, SIADHwas diagnosed.

Citalopram, suspected as the causative agent, waswithdrawn. The man’s symptoms and hyponatraemiapersisted despite water restriction and a hypertonic sodiumchloride infusion was started. Attempts to withdraw theinfusion over 3 weeks failed and tolvaptan 15 mg/day wasintroduced, with normalisation of his sodium levels.Treatment was withdrawn and he remained asymptomaticand normonatraemic 4 months after discharge.Pinal-Fernandez I, et al. Tolvaptan in antidiuretic hormone secretion syndromesecondary to treatment with citalopram. Revista Clinica Espanola 211: 491-2, No.9, Oct 2011 [Spanish; summarised from a translation] - Spain 803071344

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Reactions 2 Jun 2012 No. 14040114-9954/10/1404-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved