SIADH is a condition characterized by hypo-osmolality and hyponatremia. The most common cause of SIADH is the use of certain medications. Although many drugs have been associated with SIADH, several medication classes are more often involved.
These include antidepressants, analgesics, cytotoxic, antipsychotic agents as well anti-convulsant medications. Other potential causes include cancer, pulmonary disease, head trauma, and central nervous system disorders.
The diagnostic criteria for SIADH include hyponatremia, hypo-osmolality, euvolemic hyponatremia, and increased urine sodium in the absence of increased urination.
Treatment of SIADH typically involves fluid restriction and the use of medications to increase urine output (vaptans cause free water loss). A mnemonic for remembering this is : SIADH Cannot Void
Causes of SIADH
SIADH Cannot Void
- S: SSRIs (Sertaline)
- I: Indomethacin (Analgesics)
- A: Antidepressants (Tricyclics)
- D: Diuretics (Thiazides)
- H: Haloperidol
- Cannot: Cyclophosphamide, Carbamazepine
- Void: Vincristine
An infographic of the mnemonic (SIADH)
References
Shepshelovich D, Schechter A, Calvarysky B, Diker-Cohen T, Rozen-Zvi B, Gafter-Gvili A. Medication-induced SIADH: distribution and characterization according to medication class. Br J Clin Pharmacol. 2017;83(8):1801-1807.
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