Agomelatine as Antidepressant Treatment in Elderly Patients With Previous Hyponatremia Due To SSRI Use: Case Series

Hum Psychopharmacol. 2025 Jan;40(1):e2914. doi: 10.1002/hup.2914.

Abstract

Objective: To evaluate agomelatine treatment in elderly patients with major depressive disorder (MDD) who developed hyponatremia while using selective serotonin receptor inhibitors (SSRIs).

Methods: Patients (60 years or older) with hyponatremia after SSRI treatment for MDD were changed to agomelatine 50 mg/day during one month to observe sodium levels during the treatment and change in depressive symptoms. Montgomery-Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression Scale (CGI) of severity were used before and after treatment with agomelatine.

Results: The mean age of our sample (five patients) was 75.3 (SD ± 7.8) years. Sodium levels while using SSRIs were reported with a mean of 122.54 (SD ± 10.8) mEq/L. Mean MADRS and CGI scores on SSRIs before treatment with agomelatine were 27.8 (SD ± 3.90) and 5 (SD ± 0.71) respectively. After 4 weeks of treatment with agomelatine 50 mg/day, mean scores of sodium were reported at 135.48 (SD ± 1.6) mEq/L, and mean MADRS and CGI scores were 13.6 (SD ± 8.35) and 2.4 (SD ± 1.5). The difference in means of the MADRS scale before and after treatment with agomelatine was found to be statistically significant (27.8 [3.89] versus 13.6 [8.35], p = < 0.01).

Conclusion: Our open observational study suggests that agomelatine represents a safe and effective treatment option for elderly patients with major depressive disorder and previous SSRIs-induced hyponatremia.

MeSH terms

  • Acetamides* / adverse effects
  • Acetamides* / therapeutic use
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents* / adverse effects
  • Antidepressive Agents* / therapeutic use
  • Depressive Disorder, Major* / drug therapy
  • Female
  • Humans
  • Hyponatremia* / chemically induced
  • Male
  • Middle Aged
  • Naphthalenes
  • Psychiatric Status Rating Scales
  • Selective Serotonin Reuptake Inhibitors* / adverse effects
  • Treatment Outcome

Substances

  • agomelatine
  • Acetamides
  • Selective Serotonin Reuptake Inhibitors
  • Antidepressive Agents
  • Naphthalenes