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Rapid-onset hyponatremia and delirium following duloxetine treatment for postherpetic neuralgia: Case report and literature review.
Medicine (Baltimore) 2018 November
RATIONALE: Hyponatremia following duloxetine treatment has been reported in patients with major depressive disorder, fibromyalgia, diabetic neuropathy, or sciatic pain. The manifestations of duloxetine-induced hyponatremia are varying in different individuals. The overall prognosis for this type of hyponatremia is favorable if properly managed.
PATIENT CONCERNS AND DIAGNOSES: Herein, we reported rapid-onset hyponatremia and delirium in an older patient after 2 doses of duloxetine, which was used to control his postherpetic neuralgia. Laboratory examinations revealed a rapid decline in serum sodium level and indicated the possibility of syndrome of inappropriate antidiuretic hormone (SIADH).
INTERVENTIONS: Discontinuation of duloxetine, restriction of water intake, and intravenous supplement of normal saline were adopted to manage the hyponatremia.
OUTCOMES: Serum concentration of sodium gradually normalized following aforementioned strategies.
LESSONS: Special attention to the electrolyte abnormality is recommended in old patients undergoing duloxetine treatment.
PATIENT CONCERNS AND DIAGNOSES: Herein, we reported rapid-onset hyponatremia and delirium in an older patient after 2 doses of duloxetine, which was used to control his postherpetic neuralgia. Laboratory examinations revealed a rapid decline in serum sodium level and indicated the possibility of syndrome of inappropriate antidiuretic hormone (SIADH).
INTERVENTIONS: Discontinuation of duloxetine, restriction of water intake, and intravenous supplement of normal saline were adopted to manage the hyponatremia.
OUTCOMES: Serum concentration of sodium gradually normalized following aforementioned strategies.
LESSONS: Special attention to the electrolyte abnormality is recommended in old patients undergoing duloxetine treatment.
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