From the Research
The antidepressant least likely to cause hyponatremia is mirtazapine, as evidenced by the most recent and highest quality study 1.
Key Points
- Mirtazapine has been identified as having a lower risk of hyponatremia compared to other antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) 1, 2.
- The mechanism of action of mirtazapine, which affects noradrenergic and specific serotonergic receptors, may contribute to its lower risk of hyponatremia 2.
- While bupropion has also been considered a potential option for patients at risk of hyponatremia, the most recent evidence suggests that mirtazapine may be a better choice 1.
- It is essential to monitor sodium levels when initiating any antidepressant therapy, especially in elderly patients or those taking other medications that may affect sodium levels 3, 2.
Considerations
- Patient risk factors, such as older age and concomitant use of diuretics, should be taken into account when selecting an antidepressant 4.
- The risks and benefits of each antidepressant should be carefully weighed, considering the individual patient's medical history and current medications 1, 2.
- Regular monitoring of sodium levels and adjustment of the treatment plan as needed can help minimize the risk of hyponatremia 3, 2.