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Hyponatraemia with SSRI — GPhC CRA MCQ

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HardAdverse Drug Reactions and SafetyHyponatraemia with SSRIGPhC CRA

An 82-year-old woman started sertraline three weeks ago and now has confusion, headache and unsteadiness. She also takes bendroflumethiazide. Which investigation should the pharmacist prioritise?

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Correct answer: C — Serum sodium, renal function and clinical assessment on the same day

Sertraline can cause SIADH and hyponatraemia. Risk is higher in older people and in those taking diuretics; headache, confusion, weakness and unsteadiness are characteristic warning symptoms and may precede falls, seizures or coma. Serum sodium and clinical status require urgent assessment, with symptomatic sertraline-associated hyponatraemia prompting consideration of discontinuation under medical supervision rather than unsupervised dose escalation or salt tablets.

Reference: Sertraline SmPC: https://www.medicines.org.uk/emc/product/11992/smpc