Pharmacotherapy

Concurrent use of SSRIs and thiazide diuretics increases hyponatremia risk in older adults

March 17, 2025

Study details: This retrospective nested case-control study analyzed Medicare data from 2017 to 2019, focusing on older adults (65+) using selective serotonin reuptake inhibitors (SSRIs) or thiazide diuretics. Cases were identified based on a diagnosis of hyponatremia, while controls had no history of the condition. Logistic regression was used to assess the odds of hyponatremia with concurrent medication use.

Results: Among 551,298 SSRI users (mean age, 77.8 years) and 701,007 thiazide users (mean age, 77.1 years), the prevalence of hyponatremia was 10.4% for thiazides alone, 9.0% for SSRIs alone, and 13.0% for combined use. The adjusted odds ratio (OR) for hyponatremia was 1.24 (95% confidence interval [CI], 1.22–1.26) for SSRI users with thiazides and 1.27 (95% CI, 1.24–1.29) for thiazide users with SSRIs.

Clinical impact: The findings underscore the importance of monitoring serum sodium levels in older adults prescribed both SSRIs and thiazide diuretics. Clinicians should be vigilant for signs of hyponatremia and consider alternative therapies or dose adjustments to mitigate this risk.

Source:

Matsuura T, et al. (2025, March 4). Pharmacotherapy. Evaluation of hyponatremia among older adults exposed to selective serotonin reuptake inhibitors and thiazide diuretics. https://pubmed.ncbi.nlm.nih.gov/40035448/