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Does Venlafaxine Cause Hyponatraemia?

Posted on Thu, 11 Sep 2014

Question: I had hyponatraemia after taking Fluoxatine for 2 months and was admitted to hospital as an emergency.
I have been told never to take SSRI's as I am 72 and older people are prone to sodium depletion.
Put on Mirtazapine 15mg and this made me feel so confused, almost drunk the way I was walking and not In control of my life. Had to cancel medical appointments and one visit to a solicitor as I felt I could not think property. Took myself off the medication 2 days ago and my GP prescribed Venlafaxine 15mg.
Will this cause hyponatraemia? I hope not as I felt so ill and I please need reassurance.
My GP told me to stop taking Venlafaxine if I had side-effects I could not tolerate.

I also take low-dose Cocodamol 8/500 for generalised osteo-arthritis and, 2mg Diazepam up to 3 times a day (given for anxiety following the death of a loved one I had been nursing for 8 years). Are they compatible please. Also, if I am unable to sleep, I have been prescribed 10mg Temazepam which I have been taking for 10 years+. Your advice would be greatly appreciated.

Answered by Dr. Dr.Raju.A.T (4 hours later)

Brief Answer:
Need not worry

Detailed Answer:
Hi,

Thanks for your query.

Need not worry, Venlafaxine does not cause Hyponatraemia. Well, there are side effects associated with this medication pertaining to consciousness for sure. Since you are on Diazepam and temazepam the side effects will be nullified. You may have to worry about muscle pain and headache which can be seen in initial days of starting Venalafaxine but do not last for more than a week or two. Do check your cholesterol levels if you continue this medication for more than 6 months.

Other medications are fine. I would also add an advice to reduce the dose of Diazepam if it is ok as you are on tremazepam which has similar action.

Hope, I answered your query.

Wish you good health.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (13 hours later)

Thank you very much for your helpful and reassuring reply. I omitted to ask you at what time of day i should take the medication,please? OK in the morning if i take Temazepam 10mg at night please ? Also, don't wish to offend you, but please reassure me that you are truly a medical doctor. With many thanks. Regards, Carole

Answered by Dr. Dr.Raju.A.T (20 hours later)

Brief Answer:
Hi,

Detailed Answer:
I am a general physician having my practice here in XXXXXXX Off course this is very far away from your location. You can be able to see my details on this link here: http://doctor.healthcaremagic.com/doctors/dr-raju-a-t/60137
I am not sure how else will I prove my expertise.

As far as your question is concerned, venlafaxine is usually started at dose of 75mg preferably in the morning. The dose may be repeated in the evening if needed. Those dose adjustments should be done by your treating doctor. So please follow as instructed.

As tamazepam is prescribed to help you sleep, it is beneficial to use it at night.

Hope this answers your question.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (5 hours later)

Thank you very much for your reply to my second question regarding the anti-depressants I have been prescribed and at which time it is recommended the capsule is taken, bearing in mind I probably will be taking Temazepam at night. You have been extremely helpful. Thank you again.Dear Dr XXXXXXX this is the final question on this medication, I promise you!! Sorry I omitted to include it in the message I have just sent to you. With regard to your first response: surely you mean "exacerbate" and not "nullify* when you refer to the effects of taking Diazepam and Temazepam with Venalafaxine? Nullify means take away from but I think your secretary must have misheard your dictation because I think you were saying it would INCREASE the effect if I took both Diazepam and Temazepam? Would you clarify this, please? Hope I am not being too much of an inconvenience but I'm sure you appreciate it is very important to get it right.Dear Dr XXXXXXX This is my 2nd reminder regarding a question I asked you 2 days ago. I find this unsettling as the website promises follow-up to questions raised. I regret I have not included all my questions in the same email as it must be an inconvenience to you but I have paid for this service. If I am forgetful then it is because I am under alot of strew at the moment and I have just received the news that I have a very large macro adenoma squeezing my pituitary gland into a narrow finger shape. I should be grateful if you would answer my question of 2days ago. Many thanks and kind regards, XXXX

Dear Dr XXXXXXX I have not had a reply to the final question I had to ask on this topic and which I sent to you 1 day ago.

I regret being an inconvenience and having to ask several questions which I should have included in my initial request, but I have been recently bereaved, have physical medical issues which are on-going and I live alone - all of which do not put me in a favourable place.

I should be grateful if you could reply to my last question so that I can commence this medication. I have had Fluoxatine and was admitted as an emergeny suffering from hyponatraemia and the last anti-depressant (Mertazipine) left me feeling dazed, confused and so 'spaced out' that I had to stop taking it.

I look forward, therefore, to your further valued advice.
With kind regards, XXXX

Answered by Dr. Dr.Raju.A.T (2 days later)

Brief Answer:
They nullify

Detailed Answer:
Hi,

I am really sorry for the delay in my response. I had been very busy in attending clinical emergencies.

I shall take care not to miss your follow up or delay again.

In concern with your query. I meant nullify, the side effects of venalafexine are central nervous system excitatory type and the medications like Diazepam and Temazepam are inhibitory in their action.Hence, they nullify the side effect actions of venalafexine to some extent but not completely.

Hope, I cleared your doubt.

Wish you good health.

regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (2 hours later)

Thank you so very much, Dr XXXXXXX for your reassuring reply. I fully understand why you used the word "nullify" now! In my previous medication for depression, there was a caution relating to the use of Diazepam and Temazepam although it was still prescribed by my GP. I discontinued their use, as I felt completely out of control and very dazed/confused.

I would like to thank you for your patience in answering my several questions which, if I had had my wits about me, I would have included in my initial contact with you.

I would always use the service again and would recommend it to friends, especially for the peace of mind it gives from the expertise of such professionals as yourself.
Kind regards, Carole

Answered by Dr. Dr.Raju.A.T (1 hour later)

Brief Answer:
You are welcome

Detailed Answer:
Thanks for using this service.

Wish you good health.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar