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Paroxetine induced hyponatremia in a 52 years old male hypertensive patient
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  • Muhammad umer khan,
  • Alisha Zulifqar,
  • Raja khetpal,
  • Roomi Raja
Muhammad umer khan
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Alisha Zulifqar
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Raja khetpal
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Roomi Raja

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INTRODUCTION: Paroxetine is an antidepressant belonging to the class of SSRI. It is used in multiple psychiatric disorders including depression, anxiety and obsessive-compulsive disorder. Apart from being very efficacious, it causes some adverse effects too and hyponatremia is one of them. The association between the two is not well established, which makes this case worth of attention. CASE PRESENTATION: A 52 years old male hypertensive patient was brought to the ER after having an episode of seizure. Hyponatremia due to an unknown cause was made a provisional diagnosis. He was then referred to the psychiatric department for further assessment, where his detailed history was taken and mental state examination was performed. The patient was found to be suffering from chronic depression. The patient has been taking a combination of antipsychotics and antidepressants for this condition. Paroxetine, Olanzapine and Quetiapine were prescribed to him by his psychiatrist 10 years back, and since then he was taking it daily. His current medication was then immediately altered and paroxetine was replaced by mirtazapine. DISCUSSION/ CONCLUSION: Numerous studies have been done on the effects of SSRIs, but very few of them mentioned their association with hyponatremia. Electrolyte imbalances are common with many medications including antiepileptic and antidepressant drugs as well. Although some literature has shown the link between the two, drug induced hyponatremia remained one of the rarest adverse effect. In summary, paroxetine is very effective in the management of depression but its long-term use could result in an electrolyte imbalance in hypertensive patients