Acute Severe Hyponatremia Induced by a Duloxetine Overdose in an Elderly Woman

Wesley D Oliver; Ryan D'Angelo; Jeffrey Gonzales; Tracey Wilson; Leah S Millstein

doi:10.7759/cureus.10318

Acute Severe Hyponatremia Induced by a Duloxetine Overdose in an Elderly Woman

Cureus. 2020 Sep 8;12(9):e10318. doi: 10.7759/cureus.10318.

Authors

Wesley D Oliver¹, Ryan D'Angelo², Jeffrey Gonzales³, Tracey Wilson⁴, Leah S Millstein⁵

Affiliations

¹ Emergency Medicine, University of Maryland Medical Center, Baltimore, USA.
² Cardiology, Thomas Jefferson University Hospital, Philadelphia, USA.
³ Internal Medicine: Critical Care, None, Baltimore, USA.
⁴ Medical Intensive Care Unit, University of Maryland Medical Center, Baltimore, USA.
⁵ Internal Medicine - Pediatrics, University of Maryland School of Medicine, Baltimore, USA.

Abstract

We report a case of acute severe hyponatremia within 24 hours after a duloxetine overdose. An 82-year-old woman presented to the ED after ingesting duloxetine and diltiazem. She became hemodynamically unstable due to the diltiazem overdose and was appropriately resuscitated. During hospitalization she experienced hyponatremia consistent with syndrome of inappropriate antidiuretic hormone (SIADH). Based on the observations we concluded there was a probable relationship between the hyponatremia and the duloxetine overdose. Clinicians should monitor patients' electrolytes for acute disturbances after an overdose of duloxetine.

Keywords: duloxetine; hyponatremia; overdose; syndrome of inappropriate antidiuretic hormone secretion.

Publication types

Case Reports