Hyponatraemia during psychopharmacological treatment: results of a drug surveillance programme.

摘要: Hyponatraemia (HN) can be a life-threatening medical condition which may lead to severe neurological and psychiatric symptoms. The AMSP (Arzneimittelsicherheit in der Psychiatrie) is multicentre drug surveillance programme that assesses or new adverse reactions during psychopharmaco- logical treatment inpatients. We report on total of 263 864 inpatients monitored from 1993 2007 80 hospitals Germany, Switzerland Austria. During this period plasma sodium levels below 130 mmol/l (severe HN according AMSP) were reported 93 patients (relative frequency 0.04 %). On average, the all cases 119.7 (i5.8 S.D.) ; median 121 (range 104-129 mmol/l). Patients who showed no clinical signs (n=65, 70 %) had mean level 121.3 (i5.0 122 114-129 By contrast, with symptoms (n=28, 30 116.0 (i6.0 117 104-125 was mainly observed selective serotonin reuptake inhibitors (SSRIs) (0.06 %), Serotonin noradrenaline (SNRIs) (0.08 carbamazepine (0.10 oxcarbazepine (1.29 highest rate found for ox- carbazepine. Antipsychotics, mirtazapine tricyclic antidepressants only rarely involved (0.003-0.005 Combinations several drugs known induce significantly increased risk HN, e.g. more than 10-fold SSRI+diuretics+ACE (0.37 vs. SSRI given alone (0.02 This clinically relevant because such combinations, SSRI+diuretics occur especially elderly patients, are general at higher developing HN.