Objective  To explore the characteristics of second-generation antidepressants-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH), so as to provide reference for the clinical safe drug use.

Methods  We searched literatures on the occurrence of SIADH associated with second-generation antidepressants, and the following information of patients including general information, comorbidities, types of second-generation antidepressants, combined drugs, induction time of SIADH, sodium levels, clinical manifestations and outcomes was statistically analyzed.

Results  A total of 68 patients (from 60 articles) were collected,the male-female ratio was 1∶2.09 and the average age was (73.85±13.07) years old. Most cases of SIADH were reported after the use of 5-selective serotonin reuptake inhibitors (SSRIs). Half of the patients were treated with angiotensin converting enzyme inhibitor (ACEI) / angiotensin II receptor blockers (ARB), diuretics, proton pump inhibitors (PPI) and other drugs. The onset time of SIADH was 2-180 days after taking medication, with a median time of 10 days, of which 59 cases (86.77%) developed within 30 days; the average sodium levels in the diagnosis of SIADH was (116.59±7.57) mmol·L^-1, including 10 cases of moderate hyponatremia and 58 cases of severe hyponatremia; the main SIADH symptoms included seizures , nausea, weakness, drowsiness, pain, coma, fall, vomiting, etc. Antidepressants was discontinued after diagnosis of SIADH, and symptomatic treatment was taken such as fluid restriction and hypertonic saline, 67 patients (98.52%) recovered and the average improvement time was (6.20±4.87) days.

Conclusions  We should pay more attention to second-generation antidepressants-induced SIADH, and strengthen the follow-up for patients within 30 days of medication so as to timely diagnose and treat patients with SIADH-related symptoms.

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