Bupropion Induced Hyponatremia in an Elderly Patient:A Case Report and Review of the Literature

We present the case of a 72-year-old female with a major depressive episode who developed hyponatremia associated withbupropion. In reviewing the literature, there are only a few case reports which pertain to this topic. The clinical symptomsof hyponatremia can be misinterpreted as a worsening of the primary psychiatric illness and can lead to potentially seriousconsequences if not fully evaluated. We recommend that clinicians should be well aware of this side effect and that sodium levelsshould be checked within the first 2 weeks after initiating treatment in patients, especially those with additional risk factors forhyponatremia, such as older age, female sex, diuretic use, low BMI, and unexplained mental status changes at any time duringtreatment with antidepressants. The risk for hyponatremia associated with mirtazapine appears to be low and its use can be helpfulin patients who have developed hyponatremia induced by other antidepressants and who experienced symptoms of weight loss andinsomnia.