帕罗西汀致老年患者低钠血症

Paroxetine-induced hyponatremia in an elderly patient

1例67岁男性脑梗死患者因合并抑郁状态给予帕罗西汀20 mg,1次/d口服。5 d后患者出现乏力、情感淡漠、食欲减退。实验室检查:血钠128 mmol/L(服用帕罗西汀前为136 mmol/L)。停用帕罗西汀,改服氟哌噻吨美利曲辛,并给予氯化钠口服。1周后血钠升至134 mmol/L,淡漠及乏力感减轻。1个月后复查,血钠142 mmol/L。

A 67-year-old male patient with cerebral infarction and depression received paroxetine20 mg once daily. Five days later, the patient developed fatigue, apathy and loss of appetite. Laboratory test showed a serum sodium level of 128 mmol/L. His serum sodium level was 136 mmoL/L before paroxetine therapy. Paroxetine was discontinued and changed to flupentixol and melitraeen, and oral saline was administered. One week later, the level of serum sodium returned to 134 mmoL/L and his clinical symptoms were improved. One month later, his serum sodium level was 142 mmol/L.