A woman in her 60s with hypertension, diabetes, hyperlipidemia, and coronary artery disease was brought to the emergency department by her daughter for nausea, confusion, fatigue, and loss of appetite for 3 days. The daughter stated that the patient had been feeling sad since her sister passed away 6 weeks prior and was recently prescribed fluoxetine by her primary care physician 2 weeks earlier. On physical examination she was lethargic, only oriented to place and person, and had slow speech. Laboratory studies revealed serum sodium levels of 124 mmol/L.
Avash Das, Abhishek Maiti, Shirshendu Sinha. Antidepressant Prescription in the Geriatric PopulationA Teachable Moment. JAMA Intern Med. 2016;176(11):1608–1609. doi:10.1001/jamainternmed.2016.5535