Antidepressants and the risk of hyponatremia: a Danish register-based population study
ObjectiveTo examine the association between classes of antidepressants and hyponatremia, and between specific antidepressants and hyponatremia.DesignRetrospective register-based cohort study using nationwide registers from 1998 to 2012.SettingThe North Denmark Region.ParticipantsIn total, 638 352 in...
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creator | Leth-Møller, Katja Biering Hansen, Annette Højmann Torstensson, Maia Andersen, Stig Ejdrup Ødum, Lars Gislasson, Gunnar Torp-Pedersen, Christian Holm, Ellen Astrid |
description | ObjectiveTo examine the association between classes of antidepressants and hyponatremia, and between specific antidepressants and hyponatremia.DesignRetrospective register-based cohort study using nationwide registers from 1998 to 2012.SettingThe North Denmark Region.ParticipantsIn total, 638 352 individuals were included.Primary and secondary outcome measuresPlasma sodium was obtained from the LABKA database. The primary outcome was hyponatremia defined as plasma sodium (p-sodium) below 135 mmol/L and secondary outcome was severe hyponatremia defined as p-sodium below 130 mmol/L. The association between use of specific antidepressants and hyponatremia was analysed using multivariable Poisson regression models.ResultsAn event of hyponatremia occurred in 72 509 individuals and 11.36% (n=6476) of these events happened during treatment with antidepressants. Incidence rate ratios and CIs for the association with hyponatremia in the first p-sodium measured after initiation of treatment were for citalopram 7.8 (CI 7.42 to 8.20); clomipramine 4.93 (CI 2.72 to 8.94); duloxetine 2.05 (CI 1.44 to 292); venlafaxine 2.90 (CI 2.43 to 3.46); mirtazapine 2.95 (CI 2.71 to 3.21); and mianserin 0.90 (CI 0.71 to 1.14).ConclusionsAll antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine. |
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The primary outcome was hyponatremia defined as plasma sodium (p-sodium) below 135 mmol/L and secondary outcome was severe hyponatremia defined as p-sodium below 130 mmol/L. The association between use of specific antidepressants and hyponatremia was analysed using multivariable Poisson regression models.ResultsAn event of hyponatremia occurred in 72 509 individuals and 11.36% (n=6476) of these events happened during treatment with antidepressants. Incidence rate ratios and CIs for the association with hyponatremia in the first p-sodium measured after initiation of treatment were for citalopram 7.8 (CI 7.42 to 8.20); clomipramine 4.93 (CI 2.72 to 8.94); duloxetine 2.05 (CI 1.44 to 292); venlafaxine 2.90 (CI 2.43 to 3.46); mirtazapine 2.95 (CI 2.71 to 3.21); and mianserin 0.90 (CI 0.71 to 1.14).ConclusionsAll antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2016-011200</identifier><identifier>PMID: 27194321</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Aged ; Antidepressants ; Antidepressive Agents, Tricyclic - therapeutic use ; Citalopram - therapeutic use ; Clomipramine - therapeutic use ; Denmark - epidemiology ; Drug dosages ; Drug therapy ; Duloxetine Hydrochloride - therapeutic use ; Electrolytes ; Female ; Heart failure ; Humans ; Hyponatremia ; Hyponatremia - blood ; Hyponatremia - epidemiology ; Incidence ; Kidneys ; Laboratories ; Male ; Mianserin - analogs & derivatives ; Mianserin - therapeutic use ; Middle Aged ; Mirtazapine ; Patients ; Pharmacology and Therapeutics ; Plasma ; Population ; Prescription drugs ; Registration ; Registries ; Retrospective Studies ; Risk Factors ; Serotonin and Noradrenaline Reuptake Inhibitors - therapeutic use ; Serotonin Uptake Inhibitors - therapeutic use ; Sodium ; Sodium - blood ; Venlafaxine Hydrochloride - therapeutic use</subject><ispartof>BMJ open, 2016-05, Vol.6 (5), p.e011200-e011200</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b538t-7a8d67c811cf8d1329bf12bd53fbe04fb50ea1678f94845bf7a6778dfb04249e3</citedby><cites>FETCH-LOGICAL-b538t-7a8d67c811cf8d1329bf12bd53fbe04fb50ea1678f94845bf7a6778dfb04249e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/6/5/e011200.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/6/5/e011200.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27526,27527,27901,27902,53766,53768,77570,77601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27194321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leth-Møller, Katja Biering</creatorcontrib><creatorcontrib>Hansen, Annette Højmann</creatorcontrib><creatorcontrib>Torstensson, Maia</creatorcontrib><creatorcontrib>Andersen, Stig Ejdrup</creatorcontrib><creatorcontrib>Ødum, Lars</creatorcontrib><creatorcontrib>Gislasson, Gunnar</creatorcontrib><creatorcontrib>Torp-Pedersen, Christian</creatorcontrib><creatorcontrib>Holm, Ellen Astrid</creatorcontrib><title>Antidepressants and the risk of hyponatremia: a Danish register-based population study</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectiveTo examine the association between classes of antidepressants and hyponatremia, and between specific antidepressants and hyponatremia.DesignRetrospective register-based cohort study using nationwide registers from 1998 to 2012.SettingThe North Denmark Region.ParticipantsIn total, 638 352 individuals were included.Primary and secondary outcome measuresPlasma sodium was obtained from the LABKA database. The primary outcome was hyponatremia defined as plasma sodium (p-sodium) below 135 mmol/L and secondary outcome was severe hyponatremia defined as p-sodium below 130 mmol/L. The association between use of specific antidepressants and hyponatremia was analysed using multivariable Poisson regression models.ResultsAn event of hyponatremia occurred in 72 509 individuals and 11.36% (n=6476) of these events happened during treatment with antidepressants. Incidence rate ratios and CIs for the association with hyponatremia in the first p-sodium measured after initiation of treatment were for citalopram 7.8 (CI 7.42 to 8.20); clomipramine 4.93 (CI 2.72 to 8.94); duloxetine 2.05 (CI 1.44 to 292); venlafaxine 2.90 (CI 2.43 to 3.46); mirtazapine 2.95 (CI 2.71 to 3.21); and mianserin 0.90 (CI 0.71 to 1.14).ConclusionsAll antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine.</description><subject>Adult</subject><subject>Aged</subject><subject>Antidepressants</subject><subject>Antidepressive Agents, Tricyclic - therapeutic use</subject><subject>Citalopram - therapeutic use</subject><subject>Clomipramine - therapeutic use</subject><subject>Denmark - epidemiology</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>Duloxetine Hydrochloride - therapeutic use</subject><subject>Electrolytes</subject><subject>Female</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Hyponatremia</subject><subject>Hyponatremia - blood</subject><subject>Hyponatremia - epidemiology</subject><subject>Incidence</subject><subject>Kidneys</subject><subject>Laboratories</subject><subject>Male</subject><subject>Mianserin - analogs & derivatives</subject><subject>Mianserin - therapeutic use</subject><subject>Middle Aged</subject><subject>Mirtazapine</subject><subject>Patients</subject><subject>Pharmacology and Therapeutics</subject><subject>Plasma</subject><subject>Population</subject><subject>Prescription drugs</subject><subject>Registration</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Serotonin and Noradrenaline Reuptake Inhibitors - therapeutic use</subject><subject>Serotonin Uptake Inhibitors - therapeutic use</subject><subject>Sodium</subject><subject>Sodium - blood</subject><subject>Venlafaxine Hydrochloride - therapeutic use</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU1rHSEUhqU0NCHNLygUoZtuJlXHzy4KIf2EQDZJt6Kj5no7o1N1Avffd9J7G9Ku6kbB5305hweAVxidY9zzd3ba5tmnjiDMO4QxQegZOCGI0o4jxp4_eR-Ds1q3aD2UKcbIC3BMBFa0J_gEfL9ILTo_F1-rSa1CkxxsGw9LrD9gDnCzm3MyrfgpmvfQwI8mxbqBxd_F2nzprKnewTnPy2hazAnWtrjdS3AUzFj92eE-BbefP91cfu2urr98u7y46izrZeuEkY6LQWI8BOlwT5QNmFjH-mA9osEy5A3mQgZFJWU2CMOFkC5YRAlVvj8FH_a982In7wafWjGjnkucTNnpbKL--yfFjb7L95pKQTGia8HbQ0HJPxdfm55iHfw4muTzUjUWClFOCVcr-uYfdJuXktb1flNSccXFSvV7aii51uLD4zAY6Qd1-qBOP6jTe3Vr6vXTPR4zf0StwPkeWNP_1fgLzCCmRg</recordid><startdate>20160518</startdate><enddate>20160518</enddate><creator>Leth-Møller, Katja Biering</creator><creator>Hansen, Annette Højmann</creator><creator>Torstensson, Maia</creator><creator>Andersen, Stig Ejdrup</creator><creator>Ødum, Lars</creator><creator>Gislasson, Gunnar</creator><creator>Torp-Pedersen, Christian</creator><creator>Holm, Ellen Astrid</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160518</creationdate><title>Antidepressants and the risk of hyponatremia: a Danish register-based population study</title><author>Leth-Møller, Katja Biering ; Hansen, Annette Højmann ; Torstensson, Maia ; Andersen, Stig Ejdrup ; Ødum, Lars ; Gislasson, Gunnar ; Torp-Pedersen, Christian ; Holm, Ellen Astrid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b538t-7a8d67c811cf8d1329bf12bd53fbe04fb50ea1678f94845bf7a6778dfb04249e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antidepressants</topic><topic>Antidepressive Agents, Tricyclic - therapeutic use</topic><topic>Citalopram - therapeutic use</topic><topic>Clomipramine - therapeutic use</topic><topic>Denmark - epidemiology</topic><topic>Drug dosages</topic><topic>Drug therapy</topic><topic>Duloxetine Hydrochloride - therapeutic use</topic><topic>Electrolytes</topic><topic>Female</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Hyponatremia</topic><topic>Hyponatremia - blood</topic><topic>Hyponatremia - epidemiology</topic><topic>Incidence</topic><topic>Kidneys</topic><topic>Laboratories</topic><topic>Male</topic><topic>Mianserin - analogs & derivatives</topic><topic>Mianserin - therapeutic use</topic><topic>Middle Aged</topic><topic>Mirtazapine</topic><topic>Patients</topic><topic>Pharmacology and Therapeutics</topic><topic>Plasma</topic><topic>Population</topic><topic>Prescription drugs</topic><topic>Registration</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Serotonin and Noradrenaline Reuptake Inhibitors - therapeutic use</topic><topic>Serotonin Uptake Inhibitors - therapeutic use</topic><topic>Sodium</topic><topic>Sodium - blood</topic><topic>Venlafaxine Hydrochloride - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leth-Møller, Katja Biering</creatorcontrib><creatorcontrib>Hansen, Annette Højmann</creatorcontrib><creatorcontrib>Torstensson, Maia</creatorcontrib><creatorcontrib>Andersen, Stig Ejdrup</creatorcontrib><creatorcontrib>Ødum, Lars</creatorcontrib><creatorcontrib>Gislasson, Gunnar</creatorcontrib><creatorcontrib>Torp-Pedersen, Christian</creatorcontrib><creatorcontrib>Holm, Ellen Astrid</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leth-Møller, Katja Biering</au><au>Hansen, Annette Højmann</au><au>Torstensson, Maia</au><au>Andersen, Stig Ejdrup</au><au>Ødum, Lars</au><au>Gislasson, Gunnar</au><au>Torp-Pedersen, Christian</au><au>Holm, Ellen Astrid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antidepressants and the risk of hyponatremia: a Danish register-based population study</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2016-05-18</date><risdate>2016</risdate><volume>6</volume><issue>5</issue><spage>e011200</spage><epage>e011200</epage><pages>e011200-e011200</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectiveTo examine the association between classes of antidepressants and hyponatremia, and between specific antidepressants and hyponatremia.DesignRetrospective register-based cohort study using nationwide registers from 1998 to 2012.SettingThe North Denmark Region.ParticipantsIn total, 638 352 individuals were included.Primary and secondary outcome measuresPlasma sodium was obtained from the LABKA database. The primary outcome was hyponatremia defined as plasma sodium (p-sodium) below 135 mmol/L and secondary outcome was severe hyponatremia defined as p-sodium below 130 mmol/L. The association between use of specific antidepressants and hyponatremia was analysed using multivariable Poisson regression models.ResultsAn event of hyponatremia occurred in 72 509 individuals and 11.36% (n=6476) of these events happened during treatment with antidepressants. Incidence rate ratios and CIs for the association with hyponatremia in the first p-sodium measured after initiation of treatment were for citalopram 7.8 (CI 7.42 to 8.20); clomipramine 4.93 (CI 2.72 to 8.94); duloxetine 2.05 (CI 1.44 to 292); venlafaxine 2.90 (CI 2.43 to 3.46); mirtazapine 2.95 (CI 2.71 to 3.21); and mianserin 0.90 (CI 0.71 to 1.14).ConclusionsAll antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>27194321</pmid><doi>10.1136/bmjopen-2016-011200</doi><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Antidepressants Antidepressive Agents, Tricyclic - therapeutic use Citalopram - therapeutic use Clomipramine - therapeutic use Denmark - epidemiology Drug dosages Drug therapy Duloxetine Hydrochloride - therapeutic use Electrolytes Female Heart failure Humans Hyponatremia Hyponatremia - blood Hyponatremia - epidemiology Incidence Kidneys Laboratories Male Mianserin - analogs & derivatives Mianserin - therapeutic use Middle Aged Mirtazapine Patients Pharmacology and Therapeutics Plasma Population Prescription drugs Registration Registries Retrospective Studies Risk Factors Serotonin and Noradrenaline Reuptake Inhibitors - therapeutic use Serotonin Uptake Inhibitors - therapeutic use Sodium Sodium - blood Venlafaxine Hydrochloride - therapeutic use |
title | Antidepressants and the risk of hyponatremia: a Danish register-based population study |
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