DISCUSSION
Depression is one of the most common psychiatric disorders, affecting
almost 350 million people around the world. It often leads to severe
chronic functional impairment due to its symptoms.7 Executive
function, memory, attention, processing speed and psychomotor functions
are the cognitive domains which usually get affected
significantly.8 American psychiatric association and other
numerous guidelines have recommended both psychotherapy as well as
pharmacotherapy for the management of depressive disorders. Selective
serotonin reuptake inhibitors (SSRIs) are the preferred choice of
pharmacotherapy in depression.9
Paroxetine is a phenylpiperidine derivative, was prescribed to this
patient 10 years back, and since then he has been taking it on a regular
basis. Paroxetine is the most potent inhibitor in the class of SSRI, and
is used in the treatment of multiple disorders like depression, anxiety,
obsessive-compulsive disorders, post-traumatic stress disorder and panic
disorders.1 While being very efficacious, SSRI are known to have
an association with increased chances of developing hyponatremia. The
major risk factors that contribute to this adverse effect are the
advancing age and the concomitant use of diuretics.10 The
incidence of developing hyponatremia with the use of SSRI is 1 out of
1600 cases.11
Our patient was a 52 years old hypertensive male, who had been taking
antidepressants along with antihypertensive drugs. Therefore, he was at
an increased risk of developing electrolyte imbalance.