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Hyponatraemia SSRI thiazide — DGM MCQ

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HardPolypharmacyHyponatraemia SSRI thiazideDGM

A 79-year-old woman has falls, confusion and serum sodium of 124 mmol/L. She started an antidepressant one month ago and takes a thiazide-like diuretic. She is euvolaemic on examination. Current medicines include sertraline, indapamide and levothyroxine. Which medication should be reviewed?

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Correct answer: E — Sertraline and indapamide

SSRIs and thiazide-like diuretics can contribute to hyponatraemia in older adults and should be reviewed. Levothyroxine, paracetamol, colecalciferol and macrogol are less likely to be responsible for this biochemical picture. Hyponatraemia can present as falls or delirium rather than thirst or seizures.

Reference: BNF; STOPP/START criteria v3