How do you manage patients who develop SIADH secondary to an SSRI but have had a strong positive response to that same medication?

What monitoring strategies (e.g., sodium checks, fluid restriction, dose adjustments) have you found most practical in these cases? In what situations, if any, do you consider rechallenging with the same SSRI after hyponatremia resolves?

Answer from: at Community Practice

Management of SSRI-induced SIADH depends on the severity of hyponatremia and the patient’s psychiatric response to treatment. In mild cases (serum sodium >130), I always continue SSRI with close monitoring and fluid restriction. Moderate to severe hyponatremia, I discontinue SSRI and active...

Comments

at Thapar Renu K Office
I agree with Dr. @Jafferany. Although the surveil...

at Rancho Cucamonga
How often does this occur in your practice? I...

at Central Michigan University
Yes, the wide majority are over 65. Rarely ever se...

at Miami Va Healthcare System
Any recommendations for antipsychotics you have fo...

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How do you manage patients who develop SIADH secondary to an SSRI but have had a strong positive response to that same medication?

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