BMJ  2006;332:853 (8 April), doi:10.1136/bmj.332.7545.853-b

Letter

Disorders of sodium balance

Hyponatraemia and drug use (and abuse)

The first 100% of the full text of this article appears below.

EDITOR—In their article on disorders of sodium balance Reynolds et al did not mention the role of prescribed drugs,¹ particularly under the mantle of "iatrogenic causes"—or indeed illicit drug use²—despite citing Adrogué and Madias.³

Many drugs are implicated in inappropriate secretion of antidiuretic hormone, including most of the selective serotonin reuptake inhibitors (SSRIs, Prozac-like drugs), which can present with life threatening seizures. It would have been useful to gently remind a general readership of this, and the need to take a drug history.

Tameside General Hospital, Ashton Under Lyne, Lancashire OL6 9RW gerard_mcdade@hotmail.com

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Competing interests: None declared.

1. Reynolds RM, Padfield PL, Seckl JR. Disorders of sodium balance. BMJ 2006;332: 702-5. (25 March.)[Free Full Text]
2. Matthai SM, Davidson DC, Sills JA, Alexandrou D. Cerebral oedema after ingestion of MDMA ("ecstasy") and unrestricted intake of water. BMJ 1996;312: 1359/b.[Free Full Text]
3. Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med 2000;342: 1581-9.[Free Full Text]

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