Severe Symptomatic Hyponatremia Secondary to Escitalopram-Induced SIADH: A Case Report with Literature Review

Table 3

Summary of all reported cases of SIADH associated with escitalopram.

Case Report	Age	Sex	Escitalopram Dose	Onset; (Days)	Sodium; Levels (mEq/L)	Presenting Symptoms	Treatment given	Resolution; (Weeks)	Comorbid conditions	Medications	Remarks
Nashoni et al, 2004 [8]	62	F	10 mg	21	110	Syncope	Medication discontinuation	1 week	Hypertension, Hyperlipidemia; Atrial fibrillation; Protein C deficiency; Osteoporosis	Losartan; Simvastatin; Sotalol; Warfarin; Calcium; Vitamin D	Patient was later treated with Mirtazapine for depression
Nirmalani et al, 2006 [22]	50	M	20 mg	28	121	Weakness; Dizziness	Medication discontinuation; Fluid Restriction	5 days	Depression with Psychotic features,; Hypertension,; COPD; Osteoarthritis; GERD	Risperidone
Adiga et al, 2006 [12]	81	F	10 mg	21	120	Generalized weakness &; Recurrent Falls	Medication discontinuation; Hypertonic saline	1 week	Alzheimer's' disease Hypertension; Osteoporosis	Ramipril; Alendronic acid; Donepezil; Mirtazapine; HCTZ	Patient noted to have Renal tubular defect
Grover et al, 2007 [14]	67	F	10 mg	28	127	Delirium	Medication discontinuation	4 weeks	Bipolar affective disorder; Hypertension; Diabetes mellitus	Sodium valproate; HCTZ; Gliclazide; Aspirin; Losartan	Patient was later treated with Mirtazapine & Valproate for Moderate depression
Grover et al, 2007 [14]	75	M	10 mg	10	126	Seizures	Medication discontinuation	2 weeks	Hypertension; Generalized anxiety disorder	Atenolol; Amlodipine	Patient was later treated with Mirtazapine for Generalized Anxiety disorder
Covyeou et al, 2007 [13]	75	F	Unknown	5	116	Unknown	Medication discontinuation	5 days	Hypertension	Amlodipine; HCTZ; Aspirin; Omeprazole; Alprazolam
Koski et al, 2009 [9]	97	F	5 mg	7	113	Recurrent Falls & Confusion	Medication discontinuation; Fluid restriction; Hypertonic saline	Unknown	Hypertension, Anxiety; UTI (diagnosed 1 day prior to hospitalization)	Tolterodine; Atenolol; Furosemide; Lisinopril; Docusate; Ciprofloxacin; (started 1 day prior to hospitalization)
Tsai et al; 2012 [11]	73	F	10 mg	>60	124; 122	Delirium	Medication discontinuation; Fluid restriction	2 weeks; 1 week	Lewy body dementia	Trihexyphenidyl Bethanechol; Tamsulosin	Failed rechallenge of escitalopram as patient developed Hyponatremia
Pae et al, 2013 [10]	47	M	5 mg	2	110	Seizure	Medication discontinuation	4 days	Quadriplegia with Spinal A-V Malformation; Depression	No other medication
Soysal et al, 2014 [23]	76	F	10mg	28	113	Confusion; Lethargy; Incontinence	Medication discontinuation; Hypertonic saline	Unknown	Hypertension Diabetes mellitus, Alzheimer’s disease; Sleep disorder	Losartan; Sitagliptin; Rivastigmine; Memantine; Trazodone
Diken et al, 2016 [15]	59	M	10 mg	7	107	Confusion, Hallucination, Drowsiness	Medication discontinuation; Fluid restriction; Hypertonic saline	4 days	COPD; Diabetes mellitus	Aspirin, metoprolol perindopril amiodarone; Spironolactone Hydrochlorothiazide	Recent introduction of hydrochlorothiazide
Parmar et al, 2016 [20]	50	M	10 mg	3	94	Seizure	Medication discontinuation	5 days	Hypertension; Panic disorder	Telmisartan; Aspirin	Developed central pontine myelinolysis from rapid correction of sodium
Rawal et al, 2017 [24]	54	F	Unknown	4	116	Seizure	Medication discontinuation; Fluid restriction	Unknown	Hypertension; Depression	Telmisartan; Salt restriction
Vidyasagar et al, 2017 [25]	58	F	Unknown	14	107	Severe Constipation	Medication discontinuation; High salt diet; Fluid restriction	Unknown	Seronegative spondyloarthropathy; Diabetes mellitus; Dysthymia	Prednisolone, Hydroxychloroquine; Methotrexate; Insulin