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Drug-Induced Syndrome of Inappropriate Antidiuretic Hormone Secretion

Causes, Diagnosis and Management

  • Review Article
  • Adverse Effects
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Summary

Hyponatraemia is common among the elderly, and may be caused by physiological changes, disease processes or drugs. About half of elderly patients with hyponatraemia have features typical of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). It is important to establish whether drugs are the cause, as this is easily remediable.

The clinical manifestations of SIADH are predominantly attributable to hyponatraemia and serum hypo-osmolality. The severity of the signs and symptoms depends on the degree of hyponatraemia and the rapidity with which the syndrome develops.

Although a growing number of drugs have been reported to produce SIADH, most published reports concern vasopressin and its analogues, thiazide and thiazide-like diuretics, chlorpropamide, carbamazepine, antipsychotics, antidepressants and nonsteroidal anti-inflammatory drugs. Old age is a risk factor for SIADH following the use of many of these drugs. The use of these drugs in combination, excessive fluid intake and other underlying conditions that limit free water excretion increase the risk.

Drug-induced SIADH usually resolves following cessation of the offending agent(s). Additional measures are required in patients with symptomatic hyponatraemia, including fluid restriction and intravenous sodium chloride and/or furosemide (frusemide) therapy. Careful monitoring is essential, with particular attention paid to the rate and extent of correction of the hyponatraemia.

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References

  1. Miller M. Fluid and electrolyte balance in the elderly. Geriatrics 1987; 42: 65–76

    PubMed  CAS  Google Scholar 

  2. Adams KRH, Martin JA. Electrolyte disorders in the elderly. Drugs Aging 1991; 1: 254–65

    PubMed  CAS  Google Scholar 

  3. Kleinfeld M, Casimar M, Borra S. Hyponatremia as observed in a chronic disease facility. J Am Geriatr Soc 1979; 27: 156–61

    PubMed  CAS  Google Scholar 

  4. Kovacs L, Robertson GL. Disorders of water balance — hypo-natraemia and hypernatraemia. Baillieres Clin Endocrinol Metab 1992; 6: 107–27

    PubMed  CAS  Google Scholar 

  5. Beck LH, Burkart JM. Aging changes in renal function. In: Hazzard WR, Andres R, Bierman EL, et al., editors. Principles of geriatric medicine and gerontology. New York: McGraw-Hill Book Co., 1990: 555–64

    Google Scholar 

  6. Lindeman RD, van Buren HC, Raisz LG. Osmolar renal concentrating capacity in healthy young men and hospitalized patients without renal disease. N Engl J Med 1960; 262: 1306–14

    PubMed  CAS  Google Scholar 

  7. Rousseau P. Hyponatremia among older individuals. South Med J 1991; 84: 1114–8

    PubMed  CAS  Google Scholar 

  8. Miller M. Disorders of water and sodium balance. In: Abrams WB, Berkow R, editors. The Merck manual of geriatrics. Rah-way (NJ): Merck & Co., 1990: 24–35

    Google Scholar 

  9. Epstein M, Hollenberg NK. Age as a determinant of renal sodium conservation in normal man. J Lab Clin Med 1976; 84: 411–7

    Google Scholar 

  10. Phillips PA, Rolls BJ, Ledingham JCG, et al. Reduced thirst after water deprivation in healthy elderly men. N Engl J Med 1984; 311: 753–9

    PubMed  CAS  Google Scholar 

  11. Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 1967; 42: 790–806

    PubMed  CAS  Google Scholar 

  12. Verbalis JG. Hyponatraemia. Baillieres Clin Endocrinol Metab 1989; 3: 499–530

    PubMed  CAS  Google Scholar 

  13. Kovacs LK, Robertson GL. Syndrome of inappropriate anti-diuresis. Endocrinol Metab Clin North Am 1992; 21: 859–75

    PubMed  CAS  Google Scholar 

  14. Arieff AI, Llach F, Massey S. Neurological manifestations and morbidity of hyponatremia: correlation with brain water and electrolytes. Medicine 1987; 55: 121–9

    Google Scholar 

  15. Spigset O, Hedenmalm K. Hyponatraemia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by psychotropic drugs. Drug Saf 1995; 12: 209–25

    PubMed  CAS  Google Scholar 

  16. Bamford MF, Cruickshank G. Dangers of intranasal desmopressin for nocturnal enuresis [letter]. J R Coll Gen Pract 1989; 39: 345–6

    PubMed  CAS  Google Scholar 

  17. Yaouyanc G, Jonville AP, Yaouyanc-Lapalle H, et al. Seizure with hyponatremia in a child prescribed desmopressin for nocturnal enuresis. J Toxicol Clin Toxicol 1992; 30: 637–41

    PubMed  CAS  Google Scholar 

  18. Beach PS, Beach RE, Smith LR. Hyponatremic seizures in a child treated with desmopressin to control enuresis: a rational approach to fluid intake. Clin Pediatr 1992; 31: 566–9

    CAS  Google Scholar 

  19. Hamed M, Mitchell H, Clow AJ. Hyponatraemic convulsion associated with desmopressin and imipramine. BMJ 1993; 306: 1169

    PubMed  CAS  Google Scholar 

  20. Kallio J, Rautava P, Huupponen R, et al. Severe hyponatremia caused by intranasal desmopressin for noctural enuresis. Acta Paediatr 1993; 82: 881–2

    PubMed  CAS  Google Scholar 

  21. Schwab M, Wenzel D, Ruder H. Hyponatraemia and cerebral convulsion due to short term DDAVP therapy for control of enuresis nocturna. Eur J Pediatr 1996; 155: 46–8

    PubMed  CAS  Google Scholar 

  22. Williford SL, Bernstein SA. Intranasal desmopressin-induced hyponatremia. Pharmacotherapy 1996; 16: 66–74

    PubMed  CAS  Google Scholar 

  23. Robson WLM, Leung AKC. Hyponatraemia following desmopressin [letter]. BMJ 1993; 307: 64–5

    PubMed  CAS  Google Scholar 

  24. Robson WL, Norgaard JP, Leung AK. Hyponatremia in patients with nocturnal enuresis treated with DDAVP. Eur J Pediatr 1996; 155: 959–62

    PubMed  CAS  Google Scholar 

  25. Shepherd LL, Hutchinson RJ, Worden EK, et al. Hyponatremia and seizures after intravenous administration of desmopressin for surgical hemostasis. J Pediatr 1989; 114: 470–2

    PubMed  CAS  Google Scholar 

  26. Smith TJ, Gill JC, Ambruso DR, et al. Hyponatremia and seizures in young children given DDAVP. Am J Hematol 1989; 31: 199–202

    PubMed  CAS  Google Scholar 

  27. Weinstein RE, Bona RD, Altman AJ, et al. Severe hyponatremia after repeated intravenous administration of desmopressin. Am J Hematol 1989; 32: 258–61

    PubMed  CAS  Google Scholar 

  28. Brinch LJ, Jacobsen MB. Hyponatremia during therapy of von Willebrand’s disease: a life-threatening complication after desmopressin (Minitrin) infusion [in Norwegian]. Tidsskr Nor Laegeforen 1992; 112: 3670–1

    PubMed  CAS  Google Scholar 

  29. Humphries JE, Siragy H. Significant hyponatremia following DDAVP administration in a healthy adult. Am J Hematol 1993; 44: 12–5

    PubMed  CAS  Google Scholar 

  30. Marubbio AT, Lombardo RP, Holt PR. Control of variceal bleeding by superior mesenteric artery pitressin perfusions — complications and indications. Am J Dig Dis 1973; 18: 539–43

    PubMed  Google Scholar 

  31. Melo JA, Lee M, Munoz J, et al. Severe hyponatremia and bradycardia associated with intravenous vasopressin therapy for variceal hemorrhage. J Clin Gastroenterol 1995; 20: 266–8

    PubMed  CAS  Google Scholar 

  32. Castellano G, Solis-Herruzo JA, Morillas JD, et al. Antidiuretic hormone and renal function after water loading in patients with cirrhosis of the liver. Scand J Gastroenterol 1991; 26: 49–57

    PubMed  CAS  Google Scholar 

  33. Tsai YT, Lee FY, Lin HC, et al. Hyposensitivity to vasopressin in patients with hepatitis B-related cirrhosis during acute variceal hemorrhage. Hepatology 1991; 13: 407–12

    PubMed  CAS  Google Scholar 

  34. Morgan DB, Kirwan NA, Hancock KW, et al. Water intoxication and oxytocin infusion. Br J Obstet Gynaecol 1977; 84: 6–12

    PubMed  CAS  Google Scholar 

  35. D’Souza SW, Lieberman B, Cadman J, et al. Oxytocin induction of labour: hyponatraemia and neonatal jaundice. Eur J Obstet Gynecol Reprod Biol 1986; 22: 309–17

    PubMed  Google Scholar 

  36. Stratton JF, Stronge J, Boylan PC. Hyponatraemia and non-electrolyte solutions in labouring primigravida. Eur J Obstet Gynecol Reprod Biol 1995; 59: 149–51

    PubMed  CAS  Google Scholar 

  37. Higgins J, Gleeson R, Holohan M, et al. Maternal and neonatal hyponatraemia: a comparison of Hartmann’s solution with 5% dextrose for the delivery of oxytocin in labour. Eur J Ob-stet Gynecol Reprod Biol 1996; 68: 47–8

    CAS  Google Scholar 

  38. Seifer DB, Sandberg EC, Ueland K, et al. Water intoxication and hyponatremic encephalopathy from the use of an oxytocin nasal spray: a case report. J Reprod Med 1985; 30: 225–8

    PubMed  CAS  Google Scholar 

  39. Fichman MP, Vorherr H, Kleeman CR, et al. Diuretic-induced hyponatremia. Ann Intern Med 1971; 75: 853–63

    PubMed  CAS  Google Scholar 

  40. Luboshitzky R, Tal-Or Z, Barzilai D. Chlorthalidone-induced syndrome of inappropriate secretion of antidiuretic hormone. J Clin Pharmacol 1978; 18: 336–9

    PubMed  CAS  Google Scholar 

  41. Hamburger S, Koprivica B, Ellerbeck E, et al. Thiazide-induced syndrome of inappropriate secretion of antidiuretic hormone. JAMA 1981; 246: 1235–6

    PubMed  CAS  Google Scholar 

  42. Canning G, McKillop G, Slater SD. Dilutional hyponatraemia due to hydrochlorothiazide plus amiloride (Moduretic): not to be mistaken for the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Br J Clin Pract 1988; 42: 41–2

    PubMed  CAS  Google Scholar 

  43. Chan TYK, Law CB, Yeung VTF, et al. Adelphane-esidrex causing severe postural hypotension [letter]. Phar-macoepidemiol Drug Saf 1993; 2: 155–6

    Google Scholar 

  44. Chan TYK. Indapamide-induced hyponatremia and hypokale-mia. Ann Pharmacother 1995; 29: 1124–8

    PubMed  CAS  Google Scholar 

  45. Suki WN, Stinebaugh BJ, Frommer JP, et al. Physiology of diuretic action. In: Seldin DW, Giebisch G, editors. The kidney: physiology and pathophysiology. New York: Raven Press, 1985: 2127–62

    Google Scholar 

  46. Ayus JC. Diuretic-induced hyponatremia. Arch Intern Med 1986; 146: 1295–6

    PubMed  CAS  Google Scholar 

  47. Ghose RR. Plasma arginine vasopressin in hyponatraemic patients receiving diuretics. Postgrad Med J 1985; 61: 1043–6

    PubMed  CAS  Google Scholar 

  48. Sonnenblick M, Rosin AJ. Significance of the measurement of uric acid fractional clearance in diuretic induced hyponatraemia. Postgrad Med J 1986; 62: 449–52

    PubMed  CAS  Google Scholar 

  49. Byatt CM, Millard PH, Levin GE. Diuretics and electrolyte disturbances in 1000 consecutive geriatric admissions. J R Soc Med 1990; 83: 704–8

    PubMed  CAS  Google Scholar 

  50. Dyckner T, Wester PO. Effects of magnesium infusions in diuretic induced hyponatraemia. Lancet 1981; I: 585–6

    Google Scholar 

  51. Ashraf N, Locksley R, Arieff AI. Thiazide-induced hyponatremia associated with death or neurologic damage in outpatients. Am J Med 1981; 70: 1163–8

    PubMed  CAS  Google Scholar 

  52. Sonnenblick M, Friedlander Y, Rosin AJ. Diuretic-induced severe hyponatremia: review and analysis of 129 reported patients. Chest 1993; 103: 601–6

    PubMed  CAS  Google Scholar 

  53. Friedman E, Shadei M, Halkin H, et al. Thiazide-induced hyponatremia: reproducibility by single dose rechallenge and an analysis of pathogenesis. Ann Intern Med 1989; 110: 24–30

    PubMed  CAS  Google Scholar 

  54. Abramow M, Cogan E. Clinical aspects and pathophysiology of diuretic-induced hyponatremia. Adv Nephrol 1984; 13: 1–28

    CAS  Google Scholar 

  55. Mathew TH, Boyd IW, Rohan AP. Hyponatraemia due to the combination of hydrochlorothiazide and amiloride (Moduretic): Australian spontaneous reports 1977-1988. Med J Aust 1990; 152: 308–9

    PubMed  CAS  Google Scholar 

  56. Clark BA, Shannon RP, Rosa RM, et al. Increased susceptibility to thiazide-induced hyponatremia in the elderly. J Am Soc Nephrol 1994; 5: 1106–11

    PubMed  CAS  Google Scholar 

  57. Ashouri OS. Severe diuretic-induced hyponatremia in the elderly: a series of eight patients. Arch Intern Med 1986; 146: 1355–7

    PubMed  CAS  Google Scholar 

  58. Bayer AJ, Farag R, Browne S, et al. Plasma electrolytes in elderly patients taking fixed combination diuretics. Postgrad Med J 1986; 62: 159–62

    PubMed  CAS  Google Scholar 

  59. Fidler HM, Goldman J, Bielawska CA, et al. A study of plasma sodium levels in elderly people taking amiloride or triamterene in combination with hydrochlorothiazide. Postgrad Med J 1993; 69: 797–9

    PubMed  CAS  Google Scholar 

  60. Hornick P, Allen P. Acute hyponatraemia following total hip replacement. Br J Clin Pract 1990; 44: 776–7

    PubMed  CAS  Google Scholar 

  61. Elliott WJ, Weber RR, Murphy MB. A double-blind, randomized, placebo-controlled comparison of the metabolic effects of low-dose hydrochlorothiazide and indapamide. J Clin Pharmacol 1991; 31: 751–7

    PubMed  CAS  Google Scholar 

  62. Fine D, Shedrovilzky H. Hyponatremia due to chlorpropamide: a syndrome resembling inappropriate secretion of antidiuretic hormone. Ann Intern Med 1970; 72: 83–7

    PubMed  CAS  Google Scholar 

  63. Hagen GA, Frawley TF. Hyponatremia due to sulfonylurea compounds. J Clin Endocrinol 1970; 31: 570–5

    CAS  Google Scholar 

  64. Weissman PN, Shenkman L, Gregerman RI. Chlorpropamide hyponatremia: drug-induced inappropriate antidiuretic-hor-mone activity. N Engl J Med 1971; 284: 65–71

    PubMed  CAS  Google Scholar 

  65. Garcia M, Miller M, Moses AM. Chlorpropamide-induced water retention in patients with diabetes mellitus. Ann Intern Med 1971; 75: 549–54

    Google Scholar 

  66. Nisbet P. Chlorpropamide-induced hyponatraemia [letter]. BMJ 1977; I: 904

    Google Scholar 

  67. Aasen G, Frey HM. Excessive sensitivity to the hyponatremic effect of chlorpropamide in a patient with diabetes mellitus and anterior pituitary insufficiency. Acta Med Scand 1980; 208: 233–6

    PubMed  CAS  Google Scholar 

  68. Tanay A, Firemann Z, Yust I, et al. Chlorpropamide-induced syndrome of inappropriate antidiuretic hormone secretion. J Am Geriatr Soc 1981; 29: 334–6

    PubMed  CAS  Google Scholar 

  69. Zalin AM, Hutchinson CE, Jong M, et al. Hyponatraemia during treatment with chlorpropamide and Moduretic (amiloride plus hydrochlorothiazide). Br Med J Clin Res Ed 1984; 289: 659

    PubMed  CAS  Google Scholar 

  70. Kadowaki T, Hagura R, Kajinuma H, et al. Chlorpropamide-induced hyponatremia: incidence and risk factors. Diabetes Care 1983; 6: 468–71

    PubMed  CAS  Google Scholar 

  71. Hirokawa CA, Gray DR. Chlorpropamide-induced hyponatremia in the veteran population. Ann Pharmacother 1992; 26: 1243–4

    PubMed  CAS  Google Scholar 

  72. Sloan RW, Kreider RM, Luderer JR. The effect of chlorpropamide hyponatremia on mental status in a nursing home population. J Fam Pract 1983; 16: 937–42

    PubMed  CAS  Google Scholar 

  73. Nabarro JDN. Oral hypoglycaemic agents: the first thirty years. J R Coll Physicians Lond 1992; 26: 50–5

    PubMed  CAS  Google Scholar 

  74. Gossain VV, Hagen GA, Sugawara M. Drug-induced hyponatraemia in psychogenic polydipsia. Postgrad Med J 1976; 52: 720–2

    PubMed  CAS  Google Scholar 

  75. Darlow BA. Symptomatic hyponatraemia associated with tol-butamide therapy. Postgrad Med J 1977; 53: 223–4

    PubMed  CAS  Google Scholar 

  76. Lichtenberg L, Abraira C. Tolbutamide associated hyponatremia [letter]. JAMA 1978; 240: 2433–4

    PubMed  CAS  Google Scholar 

  77. Ducobu J, Dupont P. Hyponatremia induced by glipizide (letter) [in French]. Therapie 1981; 36: 597–8

    PubMed  CAS  Google Scholar 

  78. Krall LP. The treatment of NIDDM in the decade of the 90s. Diabetes Res Clin Pract 1991; 14: SI5–20

    Google Scholar 

  79. Hocken AG, Longson D. Reduction of free water clearance by chlorpropamide. BMJ 1968; I: 355–6

    Google Scholar 

  80. Moses AM, Numann P, Miller M. Mechanism of chlorpropamide-induced anti-diuresis in man: evidence for release of ADH and enhancement of peripheral action. Metabolism 1973; 22: 59–66

    PubMed  CAS  Google Scholar 

  81. Lozada ES, Gouaux J, Granki N, et al. Studies of the mode of action of the sulfonylureas phenylacetamides in enhancing the effect of vasopressin. J Clin Endocrinol Metab 1972; 34: 704–12

    PubMed  CAS  Google Scholar 

  82. Zusman RM, Keiser HR, Handler JS. Inhibition of vasopressin-stimulated prostaglandin E biosynthesis by chlorpropamide in the toad urinary bladder, mechanism of enhancement of vasopressin-stimulated water flow. J Clin Invest 1977; 60: 1348–53

    PubMed  CAS  Google Scholar 

  83. Henry DA, Lawson DH, Reavey P, et al. Hyponatraemia during carbamazepine treatment. BMJ 1977; I: 83–4

    Google Scholar 

  84. Stephens WP, Espir MLE, Tattersall RB, et al. Water intoxication due to carbamazepine. BMJ 1977; I: 754–5

    Google Scholar 

  85. Ashton MG, Ball SG, Thomas TH, et al. Water intoxication associated with carbamazepine treatment. BMJ 1977; I: 1134–5

    Google Scholar 

  86. Lahr MB. Hyponatremia during carbamazepine therapy. Clin Pharmacol Ther 1985; 37: 693–6

    PubMed  CAS  Google Scholar 

  87. Steelman R, Holmes D. Suspected inappropriate secretion of antidiuretic hormone in a male with mental retardation. Spec Care Dentist 1992; 12: 79–80

    PubMed  CAS  Google Scholar 

  88. Atalay S, Oner A, Gurer YK, et al. Fluid retention and cardio-megaly associated with carbamazepine in an epileptic child. Jpn Heart J 1993; 34: 239–43

    PubMed  CAS  Google Scholar 

  89. Yassa R, Nastase C, Camille Y, et al. Carbamazepine, diuretics, and hyponatremia: a possible interaction. J Clin Psychiatry 1987; 48: 281–3

    PubMed  CAS  Google Scholar 

  90. Kastner T, Friedman DL, Pond WS. Carbamazepine-induced hyponatremia in patients with mental retardation. Am J Ment Retard 1992; 96: 536–40

    PubMed  CAS  Google Scholar 

  91. Rado JP. Water intoxication during carbamazepine treatment. BMJ 1973; III: 479

    Google Scholar 

  92. Palladino A. Hyponatremia associated with carbamazepine therapy [letter]. Am J Psychiatry 1986; 143: 1190

    PubMed  CAS  Google Scholar 

  93. Vieweg V, Glick JL, Herring S, et al. Absence of carbamazepine-induced hyponatremia among patients also given lithium. Am J Psychiatry 1987; 144: 943–7

    PubMed  CAS  Google Scholar 

  94. Yassa R, Iskandar H, Nastase C, et al. Carbamazepine and hyponatremia in patients with affective disorder. Am J Psychiatry 1988; 145: 339–42

    PubMed  CAS  Google Scholar 

  95. Emsley RA, van der Meer H, Aalbers C, et al. Inappropriate antidiuretic state in long-term psychiatric inpatients. S Afr Med J 1990; 77: 307–8

    PubMed  CAS  Google Scholar 

  96. Appleby L. Rapid development of hyponatraemia during low-dose carbamazepine therapy [letter]. J Neurol Neurosurg Psychiatry 1984; 47: 1138

    PubMed  CAS  Google Scholar 

  97. van der Loos TL. Dilutional hyponatremia during carbamazepine treatment [letter]. Acta Clin Belg 1987; 42: 393

    PubMed  Google Scholar 

  98. Uziel Y, Pomeranz A, Jedeikin R, et al. Acute carbamazepine poisoning and hyponatremia. Child Nephrol Urol 1988–89; 9: 87–9

    PubMed  Google Scholar 

  99. Edge W, Edmonds J. Serum sodium and carbamazepine overdose [letter]. J Toxicol Clin Toxicol 1992; 30: 479–80

    PubMed  CAS  Google Scholar 

  100. O’Hare J, O’Driscoll D, Duggan B, et al. Hyponatraemia and carbamazepine intoxication. Ir J Med Sci 1980; 149: 10–4

    PubMed  Google Scholar 

  101. Seymour JF. Carbamazepine overdose: features of 33 cases. Drug Saf 1993; 8: 81–8

    PubMed  CAS  Google Scholar 

  102. Kamiyama T, Iseki K, Kawazoe N, et al. Carbamazepine-induced hyponatremia in a patient with partial central diabetes insipidus. Nephron 1993; 64: 142–5

    PubMed  CAS  Google Scholar 

  103. Brewerton TD, Jackson CW. Prophylaxis of carbamazepine-induced hyponatremia by demeclocycline in six patients. J Clin Psychiatry 1994; 55: 249–51

    PubMed  CAS  Google Scholar 

  104. Johannessen AC, Nielsen OA. Hyponatremia induced by ox-carbazepine. Epilepsy Res 1987; 1: 155–6

    PubMed  CAS  Google Scholar 

  105. Nielsen OA, Johannessen AC, Bardrum B. Oxcarbazepine-in-duced hyponatremia: a cross-sectional study. Epilepsy Res 1988; 2: 269–71

    PubMed  CAS  Google Scholar 

  106. Pendlebury SC, Moses DK, Eadie MJ. Hyponatraemia during oxcarbazepine therapy. Hum Toxicol 1989; 8: 337–44

    PubMed  CAS  Google Scholar 

  107. Steinhoff BJ, Stoll KD, Stodieck SR, et al. Hyponatremic coma under oxcarbazepine therapy. Epilepsy Res 1992; 11: 67–70

    PubMed  CAS  Google Scholar 

  108. Bichet DG, Kluge R, Howard RL, et al. Hyponatraemic states. In: Seldin DW, Giebisch G, editors. The kidney: physiology and pathophysiology. Vol 2. New York: Raven Press, 1992: 1727–51

    Google Scholar 

  109. Weitzel WD, Shraberg D, Work J. Inappropriate ADH secretion: the role of drug re-challenge. Psychosomatics 1980; 21: 771–9

    PubMed  CAS  Google Scholar 

  110. de Rivera JLG. Inappropriate secretion of antidiuretic hormone from fluphenazine therapy. Ann Intern Med 1975; 82: 811–2

    PubMed  Google Scholar 

  111. Kennedy MJ, Shelley RK, Daly PA. Potentiation of small cell lung cancer-related SIADH by trifluoperazine. Eur J Respir Dis 1987; 71: 450–4

    PubMed  CAS  Google Scholar 

  112. Ananth J, Lin KM. SIADH: a serious side effect of psychotropic drugs. Int Psychiatry Med 1986–7; 16: 401–7

    Google Scholar 

  113. Peck V, Shenkman L. Haloperidol-induced syndrome of inappropriate secretion of antidiuretic hormone. Clin Pharmacol Ther 1979; 26: 442–4

    PubMed  CAS  Google Scholar 

  114. Cordoba OA, Chapel JL. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) secondary to antipsychotic drug therapy. Mo Med 1978; 75: 177–8

    PubMed  CAS  Google Scholar 

  115. Ajlouni K, Kern MW, Tures JF, et al. Thiothixene-induced hyponatremia. Ann Intern Med 1974; 134: 1103–5

    CAS  Google Scholar 

  116. Ogilvie AD, Croy ME Clozapine and hyponatremia [letter]. Lancet 1992; 340: 672

    PubMed  CAS  Google Scholar 

  117. Luzecky MH, Burman KD, Schultz ER. The syndrome of inappropriate secretion of antidiuretic hormone associated with amitriptyline administration. South Med J 1974; 67: 495–7

    PubMed  CAS  Google Scholar 

  118. Liskin B, Walsh BT, Roose SP. Imipramine-induced inappropriate ADH secretion. J Clin Psychopharmacol 1984; 4: 146–7

    PubMed  CAS  Google Scholar 

  119. Cohen BJ, Mahelsky M, Adler L. More cases of SIADH with fluoxetine [letter]. Am J Psychiatry 1990; 147: 948–9

    PubMed  CAS  Google Scholar 

  120. Giese AA, Leibenluft E, Green S, et al. Phenelzine-associated inappropriate ADH secretion [letter]. J Clin Psychopharmacol 1989; 9: 309–10

    PubMed  CAS  Google Scholar 

  121. Peterson JC, Pollack RW, Mahoney JJ, et al. Inappropriate antidiuretic hormone secondary to a monoamine oxidase inhibitor. JAMA 1978; 239: 1422–3

    PubMed  CAS  Google Scholar 

  122. Vincent JP, Bodak A. Syndrome d’antidiurese sous psy-chotrope: une observation sous viloxazine. Ann Med Interne (Paris) 1989; 140: 322–3

    Google Scholar 

  123. Kazal LA, Hall DL, Miller LG, et al. Fluoxetine-induced SIADH: a geriatric occurrence? J Fam Pract 1993; 36: 341–3

    PubMed  Google Scholar 

  124. Blacksten JV, Birt JA. Syndrome of inappropriate secretion of antidiuretic hormone secondary to fluoxetine. Ann Phar-macother 1993; 27: 723–4

    CAS  Google Scholar 

  125. Crews JR, Potts NLS, Schreiber J, et al. Hyponatremia in a patient treated with sertraline [letter]. Am J Psychiatry 1993; 150: 1564

    PubMed  CAS  Google Scholar 

  126. Pillans PI, Coulter DM. Fluoxetine and hyponatraemia— a potential hazard in the elderly. N Z Med J 1994; 107: 85–6

    PubMed  CAS  Google Scholar 

  127. Taylor IC, McConnell JG. Severe hyponatraemia associated with selective serotonin reuptake inhibitors. Scott Med J 1995; 40: 147–8

    PubMed  CAS  Google Scholar 

  128. Leung M, Remick R. Sertraline-associated hyponatremia [letter]. Can J Psychiatry 1995; 40: 497–8

    PubMed  CAS  Google Scholar 

  129. Flint AJ, Crosby J, Genik JL. Recurrent hyponatremia associated with fluoxetine and paroxetine [letter]. Am J Psychiatry 1996; 53: 134

    Google Scholar 

  130. ten Holt WL, van Iperen CE, Schrijver G, et al. Severe hyponatremia during therapy with fluoxetine. Arch Intern Med 1996; 156: 681–2

    PubMed  CAS  Google Scholar 

  131. Burke D, Fanker S. Fluoxetine and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Aust N Z J Psychiatry 1996; 30: 295–8

    PubMed  CAS  Google Scholar 

  132. Adverse Drug Reactions Advisory Committee. Selective serotonin reuptake inhibitors and SIADH. Med J Aust 1996; 164: 562

    Google Scholar 

  133. Catalano G, Kanfer SN, Catalano MC, et al. The role of sertraline in a patient with recurrent hyponatremia. Gen Hosp Psychiatry 1996; 18: 278–83

    PubMed  CAS  Google Scholar 

  134. Bradley ME, Foote EF, Lee EN, et al. Sertraline-associated syndrome of inappropriate antidiuretic hormone: case report and review of the literature. Pharmacotherapy 1996; 16: 680–3

    PubMed  CAS  Google Scholar 

  135. Kessler J, Samuels SC. Sertraline and hyponatremia [letter]. N Engl J Med 1996; 335: 524

    PubMed  CAS  Google Scholar 

  136. Liu BA, Mittmann N, Knowles SR, et al. Hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone associated with the use of selective serotonin reuptake inhibitors: a review of spontaneous reports. Can Med Assoc J 1996; 155: 519–27

    CAS  Google Scholar 

  137. Voegeli J, Baumann P. Inappropriate secretion of antidiuretic hormone and SSRIs [letter]. Br J Psychiatry 1966; 169: 524–5

    Google Scholar 

  138. Christensen O, Sorenson HA, Almdal TP. Adverse effects of selective serotonin uptake inhibitors: hyponatremia caused by Schwartz-Bartter syndrome [in Danish]. Ugeskr Laeger 1996; 158: 6920–2

    PubMed  CAS  Google Scholar 

  139. Schattner A, Skurnik Y. Fluoxetine-induced SIADH [letter]. J Am Geriatr Soc 1996; 44: 1413

    PubMed  CAS  Google Scholar 

  140. Palmer BF, Henrich WL. Systemic complications of nonsteroi-dal anti-inflammatory drugs. Adv Intern Med 1996; 41: 605–39

    PubMed  CAS  Google Scholar 

  141. Rault RM. Case report: hyponatremia associated with nonste-roidal antiinflammatory drugs. Am J Med Sci 1993; 305: 318–20

    PubMed  CAS  Google Scholar 

  142. Cheung NT, Coley S, Sheeran T, et al. Syndrome of inappropriate secretion of antidiuretic hormone induced by diclofenac. BMJ 1993; 306: 186

    PubMed  CAS  Google Scholar 

  143. Hammerman C, Zaia W, Wu HH. Severe hyponatremia with indomethacin — a more serious toxicity than previously realized? Dev Pharmacol Ther 1985; 8: 260–7

    PubMed  CAS  Google Scholar 

  144. Subramanian D, Ayus JC. Case report: severe symptomatic hyponatremia associated with lisinopril therapy. Am J Med Sci 1992; 303: 177–9

    PubMed  CAS  Google Scholar 

  145. Castrillón JLP, Mediavilla A, Mendez MA, et al. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and enalapril. J Intern Med 1993; 233: 89–91

    PubMed  Google Scholar 

  146. Bonnema SJ. The combination of ACE inhibitor and thiazide may cause severe hyponatremia [in Danish]. Ugeskr Laeger 1993; 155: 487–8

    PubMed  CAS  Google Scholar 

  147. Tilly-Gentric A. Severe hyponatremia associated with ramipril therapy in an old woman [letter]. J Am Geriatr Soc 1995; 43: 1448–9

    PubMed  CAS  Google Scholar 

  148. Cutting HO. Inappropriate secretion of antidiuretic hormone secondary to vincristine therapy. Am J Med 1971; 51: 269–71

    PubMed  CAS  Google Scholar 

  149. Robertson GL, Bhoopalam N, Zelkowitz LH. Vincristine neu-rotoxicity and abnormal secretion of antidiuretic hormone. Arch Intern Med 1973; 132: 717–20

    PubMed  CAS  Google Scholar 

  150. Stuart MJ, Cuaso C, Miller M, et al. Syndrome of recurrent increased secretion of antidiuretic hormone following multiple doses of vincristine. Blood 1975; 45: 215–20

    Google Scholar 

  151. Escuro RS, Adelstein DJ, Carter SG. Syndrome of inappropriate secretion of antidiuretic hormone after infusional vincristine. Cleve Clin J Med 1992; 59: 643–4

    PubMed  CAS  Google Scholar 

  152. Kosmidis HV, Bouhoutsou DO, Varvoutsi MC, et al. Vincristine overdose: experience with 3 patients. Pediatr Hematol Oncol 1991; 8: 171–8

    PubMed  CAS  Google Scholar 

  153. Antony A, Robinson WA, Roy C, et al. Inappropriate antidiuretic hormone secretion after high dose vinblastine. J Urol 1980; 123: 783–4

    PubMed  CAS  Google Scholar 

  154. Stahel RA, Oelz O. Syndrome of inappropriate ADH secretion secondary to vinblastine [letter]. Cancer Chemother Pharmacol 1982; 8: 253–4

    PubMed  CAS  Google Scholar 

  155. Ravikumar TS, Grage TB. The syndrome of inappropriate ADH secretion secondary to vinblastine-bleomycin therapy. J Surg Oncol 1983; 24: 242–5

    PubMed  CAS  Google Scholar 

  156. Fraschini G, Recchia F, Holmes FA. Syndrome of inappropriate antidiuretic hormone secretion associated with hepatic arterial infusion of vinblastine in three patients with breast cancer. Tumori 1987; 73: 513–6

    PubMed  CAS  Google Scholar 

  157. Zavagli G, Ricci G, Tataranni G, et al. Life-threatening hyponatremia caused by vinblastine. Med Oncol Tumor Phar-macother 1988; 5: 67–9

    CAS  Google Scholar 

  158. Steele TH, Serpeck AA, Block JB. Antidiuretic hormone response to cyclophosphamide in man. J Pharmacol Exp Ther 1973; 185: 245–53

    PubMed  CAS  Google Scholar 

  159. De Fronzo RA, Braine H, Colvin M, et al. Water intoxication in man after cyclophosphamide therapy. Ann Intern Med 1973; 78: 861–9

    Google Scholar 

  160. Webberley MJ, Murray JA. Life-threatening acute hyponatrae-mia induced by low dose cyclophosphamide and indomethacin. Postgrad Med J 1989; 65: 950–2

    PubMed  CAS  Google Scholar 

  161. McCarron MO, Wright GD, Roberts SD. Water intoxication after low dose cyclophosphamide. BMJ 1995; 311: 292

    PubMed  CAS  Google Scholar 

  162. Cantwell BMJ, Idle M, Millard MJ, et al. Encephalopathy with hyponatraemia and inappropriate arginine vasopressin secretion following an intravenous ifosfamide infusion [letter]. Ann Oncol 1990; 1: 1232

    Google Scholar 

  163. Culine S, Ghosn N, Droz JP. Inappropriate antidiuretic hormone secretion induced by ifosfamide [letter]. Eur J Cancer 1990; 26: 922

    PubMed  CAS  Google Scholar 

  164. Izquierdo R, Leinung M. Hyponatraemia secondary to administration of ifosfamide [letter]. Eur J Cancer 1993; 29A: 2072–3

    PubMed  CAS  Google Scholar 

  165. Pratt CB, Douglass EC, Kovnar EH, et al. A phase I study of ifosfamide given on alternate days to treat children with brain tumors. Cancer 1993; 71: 3666–9

    PubMed  CAS  Google Scholar 

  166. Greenbaum-Lefkoe B, Rosenstock JG, Belasco JB, et al. Syndrome of inappropriate antidiuretic hormone secretion: a complication of high-dose intravenous melphalan. Cancer 1985; 55: 44–6

    PubMed  CAS  Google Scholar 

  167. Quesada JR, Talpaz M, Rios A, et al. Clinical toxicity of inter-ferons in cancer patients: a review. J Clin Oncol 1986; 4: 234–43

    PubMed  CAS  Google Scholar 

  168. Lei KIK, Wickham NWR, Johnson PJ. Severe hyponatremia due to a syndrome of inappropriate secretion of antidiuretic hormone in a patient receiving interferon-α for chronic my-eloid leukaemia [letter]. Am J Hematol 1995; 49: 100

    PubMed  CAS  Google Scholar 

  169. Levin L, Sealy R, Barron J. Syndrome of inappropriate antidiuretic hormone secretion following dis-dichlorodiammineplatinum II in a patient with malignant thymoma. Cancer 1982; 50: 2279–82

    PubMed  CAS  Google Scholar 

  170. Littlewood TJ, Smith AP. Syndrome of inappropriate antidiuretic hormone secretion due to treatment of lung cancer with cisplatin. Thorax 1984; 39: 636–7

    PubMed  CAS  Google Scholar 

  171. Hayes DF, Lechan RM, Posner MR, et al. The syndrome of inappropriate antidiuretic hormone secretion associated with induction chemotherapy for squamous cell carcinoma of the head and neck. J Surg Oncol 1986; 32: 150–2

    PubMed  CAS  Google Scholar 

  172. Ritch PS. Cis-dichlorodiammineplatinum II-induced syndrome of inappropriate secretion of antidiuretic hormone. Cancer 1988; 61: 448–50

    PubMed  CAS  Google Scholar 

  173. Sthoeger ZM, Breisilovsky S, Sthoeger D, et al. Syndrome of inappropriate antidiuretic hormone secretion following cis-dichlorodiammineplatinum II in a patient with laryngeal carcinoma. Eur J Med 1993; 2: 175–6

    PubMed  CAS  Google Scholar 

  174. Otsuka F, Hayashi Y, Ogura T, et al. Syndrome of inappropriate secretion of antidiuretic hormone following intra-thoracic cisplatin. Intern Med 1996; 35: 290–4

    PubMed  CAS  Google Scholar 

  175. Cunningham Jr ET, Sawchenko PE. Reflex control of mag-nocellular vasopressin and oxytocin secretion. Trends Neu-rosci 1991; 14: 406–11

    CAS  Google Scholar 

  176. Rowe JW, Shelton RL, Helderman JH, et al. Influence of the emetic reflex on vasopressin release in man. Kidney Int 1979; 16: 729–35

    PubMed  CAS  Google Scholar 

  177. Robinson BG, Clifton-Bligh P, Posen S, et al. The effect of bromocriptine on circulating vasopressin. Clin Sci 1982; 63: 367–72

    PubMed  CAS  Google Scholar 

  178. Marshall AW, Jakobovits AW, Morgan MY. Bromocriptine-as-sociated hyponatraemia in cirrhosis. BMJ 1982; 285: 1534–5

    PubMed  CAS  Google Scholar 

  179. Lammers GJ, Roos RAC. Hyponatraemia due to amantadine hydrochloride and L-dopa/carbidopa [letter]. Lancet 1993; 342: 439

    PubMed  CAS  Google Scholar 

  180. Larner AJ. Hyponatraemia and dopaminergic agents [letter]. Postgrad Med J 1994; 70: 310–1

    PubMed  CAS  Google Scholar 

  181. Halma C, Jansen JBMJ, Janssens AR, et al. Life-threatening water intoxication during somatostatin therapy. Ann Intern Med 1987; 107: 518–20

    PubMed  CAS  Google Scholar 

  182. Walker BJ, Evans PA, Forsling ML, et al. Somatostatin and water excretion in man: an intrarenal action. Clin Endocrinol 1985; 23: 169–74

    CAS  Google Scholar 

  183. Pruszczynski W, Ardaillou R. Somatostatin and water excretion [letter]. Lancet 1983; 2: 628–9

    PubMed  CAS  Google Scholar 

  184. Ishikawa S, Schrier R. Evidence for a role of opioid peptides in the osmotic and nonosmotic release of arginine vasopressin in the conscious rat. J Clin Invest 1982; 69: 666–72

    PubMed  CAS  Google Scholar 

  185. DeBodo RC. The antidiuretic action of morphine and its mechanism. J Pharmacol Exp Ther 1944; 82: 74–85

    CAS  Google Scholar 

  186. Cadnapaphornchai P, Boykin JL, Berl T, et al. Mechanism of effect of nicotine on renal water excretion. Am J Physiol 1974; 227: 1216–20

    PubMed  CAS  Google Scholar 

  187. Yamada T, Nakao K, Itoh H, et al. Opioid modulation of vasopressin secretion in conscious rats. Clin Exp Hypertens A 1988; 10 Suppl. 1: 361–7

    PubMed  Google Scholar 

  188. Wigoda P, Netscher DT, Thornby J, et al. Vasoactive effects of smoking as mediated through nicotinic stimulation of sympathetic nerve fibers. J Hand Surg (Am) 1995; 20: 718–24

    CAS  Google Scholar 

  189. Eastell R, Edmonds CJ. Hyponatraemia associated with tri-methoprim and a diuretic. BMJ 1984; 289: 1658–9

    PubMed  CAS  Google Scholar 

  190. Somani P, Temesy-Armos PN, Leighton RF, et al. Hyponatre-mia in patients treated with lorcainide, a new antiarrhythmic drug. Am Heart J 1984; 108: 1443–8

    PubMed  CAS  Google Scholar 

  191. Aron NB. Phenoxybenzamine-induced hyponatremia simulating the syndrome of inappropriate antidiuretic hormone secretion [letter]. Ann Intern Med 1987; 107: 119–20

    PubMed  CAS  Google Scholar 

  192. Soler-Bel J, Tapiz Reula A, Campo Fernandez de los Rios R, et al. Severe hyponatremia induced by clofibrate and a thiazide diuretic (letter) [in Spanish]. Med Clin (Barc) 1988; 91: 438–9

    CAS  Google Scholar 

  193. Varkel Y, Braester A, Nusem D, et al. Methyldopa-induced syndrome of inappropriate antidiuretic hormone secretion and bone marrow granulomatosis. Drug Intell Clin Pharm 1988; 22: 700–2

    PubMed  CAS  Google Scholar 

  194. Engel WR, Grau A. Inappropriate secretion of antidiuretic hormone associated with lorazepam. BMJ 1988; 297: 858

    PubMed  CAS  Google Scholar 

  195. Zawada Jr ET, Jensen RA, Williams L, et al. Plasma dilution during transdermal clonidine antihypertensive monotherapy. Int J Artif Organs 1989; 12: 200–3

    PubMed  Google Scholar 

  196. Tweedy CR, Silverberg DA, Scott L. Levamisole-induced syndrome of inappropriate antidiuretic hormone [letter]. N Engl J Med 1992; 326: 1164

    PubMed  CAS  Google Scholar 

  197. Kaloustian E, Veyssier P. Severe hyponatremia: possible role of omeprazole [letter] [in French]. Presse Med 1992; 21: 907–8

    PubMed  CAS  Google Scholar 

  198. Gonthier R, Bouchou K, Guy C, et al. Severe hyponatremia induced by omeprazole (letter) [in French]. Presse Med 1993; 22: 176

    PubMed  CAS  Google Scholar 

  199. Durst RY, Pipek R, Levy Y. Hyponatremia caused by omeprazole treatment. Am J Med 1994; 97: 400–1

    PubMed  CAS  Google Scholar 

  200. Melville C, Shah A, Matthew D, et al. Electrolyte disturbance with omeprazole therapy. Eur J Pediatr 1994; 153: 49–51

    PubMed  CAS  Google Scholar 

  201. Shiba S, Sugiura K, Ebata A, et al. Hyponatremia with consciousness disturbance caused by omeprazole administration: a case report and literature review. Dig Dis Sci 1996; 41: 1615–7

    PubMed  CAS  Google Scholar 

  202. Ikeda K, Moriyasu H, Yasaka M, et al. Valproate related syndrome of inappropriate secretion of antidiuretic hormone (SIADH) — a case report [in Japanese]. Rinsho Shinkeigaku 1994; 34: 911–3

    PubMed  CAS  Google Scholar 

  203. Lohr JW. Osmotic demyelination syndrome following correction of hyponatremia: association with hypokalemia. Am J Med 1994; 96: 408–13

    PubMed  CAS  Google Scholar 

  204. Arieff AI. Management of hyponatraemia. BMJ 1993; 307: 305–8

    PubMed  CAS  Google Scholar 

  205. Ayus JC, Arieff AI. Pathogenesis and prevention of hyponatremic encephalopathy. Endocrinol Metab Clin North Am 1993; 22: 425–46

    PubMed  CAS  Google Scholar 

  206. Miller M. Inappropriate antidiuretic hormone secretion. Curr Ther Endocrinol Metab 1994; 5: 186–9

    PubMed  CAS  Google Scholar 

  207. Höjer J. Management of symptomatic hyponatraemia: dependence on the duration of development. J Intern Med 1994; 235: 497–501

    PubMed  Google Scholar 

  208. Mulloy AL, Caruana RJ. Hyponatremic emergencies. Med Clin North Am 1995; 79: 155–168

    PubMed  CAS  Google Scholar 

  209. Oh MS, Kim HJ, Carrol HJ. Recommendations for treatment of symptomatic hyponatremia. Nephron 1995; 70: 143–50

    PubMed  CAS  Google Scholar 

  210. Zarinetchi F, Berl T. Evaluation and management of severe hyponatremia. Adv Intern Med 1996; 41: 251–83

    PubMed  CAS  Google Scholar 

  211. Sterns RH. Severe symptomatic hyponatremia: treatment and outcome: a study of 64 cases. Ann Intern Med 1987; 107: 656–64

    PubMed  CAS  Google Scholar 

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  1. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong

    Thomas Y. K. Chan

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Chan, T.Y.K. Drug-Induced Syndrome of Inappropriate Antidiuretic Hormone Secretion. Drugs & Aging 11, 27–44 (1997). https://doi.org/10.2165/00002512-199711010-00004

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