SynthesisEuropean psychiatry : the journal of the Association of European Psychiatrists2024
The risk of antidepressant-induced hyponatremia: A meta-analysis of antidepressant classes and compounds.
Synthesis in European psychiatry : the journal of the Association of European Psychiatrists, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Risk of antidepressant-induced hyponatremia in geriatric patients: a systematic review and meta-analysis.BMC geriatrics · 2026Pooled it
- The risk of hyponatremia induced by SSRIs and SNRIs antidepressants: a systematic review and meta-analysis.BMC pharmacology & toxicology · 2025Pooled it
- Discovery of novel Kir4.1 inhibitors based on serdemetan with potential therapy for glioblastoma-depression comorbidity.Pharmaceutical science advances · 2026Article
- Serotonergic Toxicity and Hyponatremia Associated with Antidepressant Therapy: The Pivotal Role of SIADH.Clinical drug investigation · 2026Review
- Hyponatremia risk with antidepressant use: A retrospective study.Journal of the Chinese Medical Association : JCMA · 2026Article
- Antidepressants and the risk of hyponatremia: A multi-institutional cohort study using observational medical outcomes partnership-Common Data Model.British journal of clinical pharmacology · 2026Observational
- Persistent Delirium in the Elderly: A Case Report and Review of Multifactorial Contributors and Management Challenges.Case reports in psychiatry · 2026Article
- Review
- The interplay between serotonin syndrome and syndrome of inappropriate antidiuresis: a fatal case of acute hyponatremia during treatment with duloxetine, chlorphenamine, amitriptyline, and L-tryptophan.Therapeutic advances in psychopharmacology · 2026Article
- Poststroke anxiety and depression: epidemiology, mechanisms, and management strategies.Frontiers in psychiatry · 2026Review
- Novel anxiolytic-antidepressant combinations TF-1 and TF-2 and their intervention mechanisms in a mouse model of comorbid anxiety and depression (CAD).Frontiers in pharmacology · 2026Article
- Risk factors of linezolid-associated hyponatremia from a retrospective case-control study: decreased serum albumin as a selective predictor in elder patients.Annals of medicine · 2025Article
- Managing depression in the elderly: real-world clinical considerations and perspectives.International clinical psychopharmacology · 2025Article
- Drug-Induced Hyponatremia: Insights into Pharmacological Mechanisms and Clinical Practice Management.Journal of clinical medicine · 2025Review
- Treatment with antidepressant drugs and hyponatremia: a network meta-analysis.Journal of endocrinological investigation · 2025Article
- Neuroinflammation and Natural Antidepressants: Balancing Fire with Flora.Biomedicines · 2025Review
- Evaluation of hyponatremia among older adults exposed to selective serotonin reuptake inhibitors and thiazide diuretics.Pharmacotherapy · 2025Article
- Approach to the increase of depression and its treatment. Role of primary care. An opinion article.Frontiers in health services · 2025Article
- Comparison of the Incidence and Magnitude of Hyponatremia Among Patients With Poststroke Depression Receiving Either Escitalopram or Sertraline.Pharmacology research & perspectives · 2024Observational
Corrections and comments
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyponatremia (hypoNa) is a potentially serious adverse event of antidepressant treatment. Previous research suggests the risk of drug-induced hyponatremia differs between antidepressants. This meta-analysis sought to determine the risk of antidepressant-induced hypoNa, stratified by different compounds and classes.
methodsA PRISMA-compliant systematic search of Web of Science and PubMed databases was performed from inception until Jan 5, 2023, for original studies reporting incidences or risks of hypoNa in adults using antidepressants. We modelled random-effects meta-analyses to compute overall event rates and odds ratios of any and clinically relevant hypoNa for each compound and class, and ran head-to-head comparisons based on hypoNa event rates. We conducted subgroup analyses for geriatric populations and sodium cut-off value. The study is registered with PROSPERO, CRD42021269801.
resultsWe included 39 studies (n = 8,175,111). Exposure to antidepressants was associated with significantly increased odds of hypoNa (k = 7 studies, OR = 3.160 (95%CI 1.911-5.225)). The highest event rates were found for SNRIs (7.44%), SSRIs (5.59%), and TCAs (2.66%); the lowest for mirtazapine (1.02%) and trazodone (0.89%). Compared to SSRIs, SNRIs were significantly more likely (k = 10, OR = 1.292 (1.120 - 1.491), p < 0.001) and mirtazapine significantly less likely (k = 9, OR = 0.607 (0.385 - 0.957), p = 0.032) to be associated with hypoNa.
conclusionOur meta-analysis demonstrated that, while no antidepressant can be considered completely risk-free, for hypoNa-prone patients mirtazapine should be considered the treatment of choice and SNRIs should be prescribed more cautiously than SSRIs and TCAs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.