Bipolar bozuklukta stabil yüksek doz risperidon sonrası oluşan hiponatremi: Bir olgu sunumu

Abstract

Risperidone is a commonly prescribed atypical antipsychotic. Hyponatremia has been reported rarely as an adverse effect of risperidone. We report a case of a patient with bipolar affective disorder, who developed the syndrome of inappropriate antidiuretic hormone secretion, probably induced by high dose risperidone. A 60-year-old male with bipolar affective disorder, who was on risperidone 6 mg per day and sodium valproate 1200 mg per day, developed lethargy, unsteady gait, disorientation for the past 4 days followed by fever and productive cough with yellow sputum. Laboratory screening revealed that the serum sodium level was 117 mol/L, the urine sodium concentration was 106 mmol/L and plasma osmolarity was 260.57 mmol/Kg. A diagnosis of the syndrome of inappropriate antidiuretic hormone secretion was made. Risperidone was thought of as a precipitating agent and changed over to olanzapine resulting in improvement in hyponatremia. In this patient, high-dose risperidone treatment was the most probable cause, and the mechanisms may be related to risperidone's high affinity for the 5-hydroxytryptamine 2A and dopamine 2 receptors.