Hyponatremia is an uncommon but widely reported complication of selective serotonin
uptake inhibitors (SSRIs), and most of the case reports involve elderly patients.
The presentation is usually that of SIADH, but the underlying mechanism leading to
the syndrome is poorly understood. Since the use of SSRIs is becoming more popular
among elderly depressed patients and because of the potentially serious consequence
of hyponatremia, psychiatrists should be alert to the development of the complication
and familiarize themselves with its diagnosis and treatment. We report two elderly
patients who were identified to have hyponatremia after the commencement of paroxetine.
This illustrates the need for monitoring of plasma sodium level if a patient's clinical
condition deteriorates. Other factors possibly related to the hyponatremia are discussed
and a review of the diagnosis and management of SSRI-related hyponatremia is included.
