The association of selective serotonin reuptake inhibitors and venlafaxine with profound hyponatremia
An erratum to this article was published (Eur J Endocrinol, 3 Aug 2026 ↗)
Authors' conclusion
There was a strong association between newly initiated SSRI/venlafaxine and profound hyponatremia. The risk increased with age and female sex affecting 1 in 15 women ≥80 years. Consequently, heightened vigilance for hyponatremia is recommended following SSRI/venlafaxine initiation, particularly in elderly patients.
Study context
- Population
- First-time users of SSRI/venlafaxine initiating treatment 2007–2017, Stockholm Sodium Cohort (health data on 1,632,249 individuals)
- Participants
- 234,217 first-time users
- Exposure
- Newly initiated SSRI/venlafaxine vs non-use periods
- Outcome
- Profound hyponatremia (plasma sodium <125 mmol/L)
Methodological detailsself-controlled (individual as own control), first-time users
- Self-controlled (individual as own control)
- First-time users
Main finding
As reported in the abstract
aOR for profound hyponatremia, first 3 months after SSRI/venlafaxine initiation
4.29
95% CI 3.34–5.52
Individuals developing profound hyponatremia at least once
3999
Observational data: associations, not effects.
Further findings
Profound hyponatremia, first 2 weeks
- aOR
- 10.06 (95% CI: 5.97-17.00)
Profound hyponatremia, after 1 year
- aOR
- 1.30 (95% CI: 0.97-1.75)
Incidence of profound hyponatremia after initiation, by age
- Age 65-79 years
- 3%
- Age ≥80 years
- 4%
Incidence of profound hyponatremia after initiation, age ≥80 years, by sex
- Women
- 6.5%
- Men
- 3.4%
Original publication
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