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Please Only Have This Question Answered By A Psychiatrist .

Posted on Mon, 22 Apr 2019

Question: Please only have this question answered by a psychiatrist. A number of years ago we were told that an elderly relative who was very unwell and in hospital at the time had to be taken off a SSRI (citalopram) because some sort of "salts" became dangerously high. We still don't know what this meant. The relative had COPD, CHF, PTSD, myeloproliferative/myelodysplastic disorder, monoclonal b cell gammopathy, anaemia and a pleural effusion. The other medications that he was on at the time were bisoprolol, paracetamol, ciproflaxin, heparin and furosemide. He was definitely not on lithium. Perhaps it is impossible to now know what the "salts" were. But could you make an educated medical guess as to what sort of "salts" that they might have been talking about?

Answered by Dr. Dr. Ashok Kumar Choudhary (2 hours later)

Brief Answer:
It was probably low sodium or high potassium

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

Citalopram causes hyponatremia (low sodium) and this is one of the dangerous salt abnormality especially among elderly with multiple disorders. It is possible that they removed citalopram due to low sodium.

In addition many of the medications used in COPD can cause high potassium and this could be the high salt as communicated to the patient.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.

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

Follow up: Dr. Dr. Ashok Kumar Choudhary (15 hours later)

Thank you Dr XXXXXXX for your reply. The only medications that I think that he was on for COPD at the time were seretide and prednisolone. Could this have caused the high level of "salts" (potassium). They definitely said that the "salts" were too high (dangerously high).

Answered by Dr. Dr. Ashok Kumar Choudhary (5 hours later)

Brief Answer:
Both the medications cause low potassium

Detailed Answer:
Hello,
Thanks for reverting back to me.

Both Seretide and prednisolone cause low potassium and were probably not the medications for dangerously high salt as communicated by treating medical team.

However the medical conditions of the patient namely myelodysplastic disorder, monoclonal b cell gammopathy could be the cause for high potassium.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and reagrds.

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