National and international pharmacovigilance committee reports and case-control studies also implicate paroxetine, fluoxetine, sertraline. However, there have been only few reported cases of hyponatremia associated with escitalopram. The objective of this case report is to highlight a strong association of hyponatremia and SIADH (Syndrome of Inappropriate ADH secretion) in a middle-aged patient receiving escitalopram, a drug less commonly known to cause such side effects. Methods: We report a case of escitalopram induced severe hyponatremia in a middle-aged man where the association of hyponatremia with escitalopram is clearly established. Patient developed hyponatremia on the rechallenge with escitalopram (serum sodium = 94 mEq/L) within two days of initiation of treatment. The patient was free from other medical illnesses and was not taking other medications known to cause hyponatremia (confounders present in previous case reports suggesting an association between escitalopram and SIADH). Results: Our case suggests a strong association of escitalopram use and development of hyponatremia and SIADH in the absence of another drug use and medical comorbidity. Conclusion: Escitalopram, an SSRI is associated with hyponatremia and SIADH even in middle-aged individuals. There is a need for case-control studies especially involving a younger and middle age group. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

BACKGROUND/AIMS: To study the prevalence of somatic and psychiatric co-morbidities in the patients of irritable bowel syndrome (IBS) and to assess the quality of life (QOL) of these patients. METHODS: One hundred and eighty-four IBS patients and 198 controls were included. Diagnosis of IBS, its sub-classification and assessment of other functional gastrointestinal disorders (FGIDs) was made on basis of Rome III criteria. Severity of IBS was assessed using IBS severity scoring system. Psychiatric evaluation was done using Patient Heath Questionnaire. QOL was evaluated using WHO QOL-BREF. RESULTS: One hundred and forty-seven (79.9%) and 158 (85.9%) patients with IBS had at least one other FGID or at least one somatic co-morbidity, respectively. Higher number of patients had at least one psychiatric co-morbidity compared to controls (79.9% vs 34.3%; P < 0.001). Major depressive syndrome (47.3% vs 5.1%; P < 0.001), somatoform disorder (50% vs 14.6%; P < 0.001) and panic syndrome (44% vs 11.6%; P < 0.001) were more common in IBS than controls. Only 14 (7.6%) patients were receiving drug treatment for their psychiatric illness. Severe IBS symptoms were present in significantly higher number of patients with constipation predominant IBS than diarrhea predominant IBS. Those with severe disease had higher prevalence of psychiatric (95.1%) and somatic (96.7%) co-morbidities compared with mild disease. QOL of IBS patients was significantly lower in all four domains compared to controls. Presence of at least one other FGID was significantly associated with presence of one or more psychiatric co-morbidity (P < 0.001). CONCLUSIONS: Majority of IBS patients presenting to a tertiary care center had associated psychiatric, somatic co-morbidities and reduced QOL. Very few of them received specific psychiatric treatment.
Anxiety Disorders ; Constipation ; Depression ; Depressive Disorder ; Diarrhea ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Panic ; Prevalence ; Quality of Life ; Surveys and Questionnaires ; Rome ; Somatoform Disorders ; Tertiary Care Centers ; Tertiary Healthcare