Table 3. Case series and case report studies clinical outcomes: descriptive characteristics of mirtazapine induced hyponatremia cases.

NS = Not Specified; BID = twice a day; ADH = antidiuretic hormone

Author	Clinical manifestations	Serum sodium levels (mEq/L)	Previous medication	Mirtazapine dosage	Time gap between administration and hyponatremia  (days)	Abnormal laboratory findings	Management
Bavbek et al. [14]	2-day history of nausea and intermittent vomiting. Patient was afebrile, with normal vital signs	115	Levodopa and citalopram, 20 mg/d, 7 months prior to treatment	15 mg nightly	153	Urine sodium of 249 mEq/L, serum osmolarity of 265 mOsm/kg and urine osmolarity of 386 mOsm/kg.	Mirtazapine therapy was discontinued, treatment with hypertonic saline at 2 mEq/L/h, tianeptine prescription when discharged.
Cheah et al. [15]	Somnolence	112	Metformin 500 mg BID, gliclazide 40 mg BID, irbesartan 150 mg daily, and hydrochlorothiazide 12.5 mg daily	15 mg daily	7	Urine osmolarity of 353 mOsm/kg; serum osmolarity of 239 mOsm/kg.	Mirtazapine therapy was discontinued, treatment with hypertonic saline, followed by fluid restriction.
Cheah et al. [15]	Confusion	113	Ramipril 5 mg daily, metoprolol 25 mg BID, furosemide 40 mg daily	30 mg daily	10	Urine osmolarity of 320 mOsm/kg; serum osmolarity of 243 mOsm/kg.	Mirtazapine and furosemide were discontinued, fluid restriction.
Ladino et al. [16]	Confusion and somnolence	116	NS	7.5 mg nightly	6	serum osmolarity of 254 mOsm/kg; serum potassium of 5.9 mmol/L.	Mirtazapine therapy was discontinued
Roxanas et al. [17]	NS	130	Venlafaxine, amiodarone, gliclazide, L-thyroxine, irbesartan, hydrochlorothiazide, alendronate, omeprazole, atorvastatin and zolpidem	15 mg nightly	4	Urine osmolarity of 398 mOsm/kg; serum osmolarity of 294 mOsm/kg.	Mirtazapine therapy was discontinued, ADH serum  level of 0.7 pmol/L
Famularo et al. [18]	Lethargy, confusion, somnolence and dysphasia	114	Telmisartan and hydrochlorothiazide	30 mg daily	58	Urine osmolarity of 450 mOsm/kg; serum osmolarity of 236 mOsm/kg	Mirtazapine therapy was discontinued, treatment with hypertonic saline.
Ghosh et al. [19]	Confusion, agitation, irritation, altered speech, poor attention, impairment of short-term memory	123	Clonazepam 0.5 mg/day	22.5 mg daily	1	None	Mirtazapine therapy was discontinued, treatment with isotonic saline.