Lansoprazole hormonal

An 89-year-old man, who was taking aspirin 325 mg/ day, clopidogrel 75 mg/day, atenolol 25 mg/day, and lansoprazole 30 mg/day, developed depression and was given citalopram 20 mg/day (35). His depressive symptoms started to improve, but after 12 days he developed malaise, nausea, and headache. His serum sodium concentration had fallen from 138 mmol/1 before citalopram to 117 mmol/1. This was due to inappropriate secretion of antidiuretic hormone. Citalopram was withdrawn, he was given intravenous saline, and 72 hours later his serum sodium was normal and his symptoms of malaise, nausea, and headache had resolved. However, his depressive symptoms worsened, so citalopram (20 mg/day) was restarted with close monitoring of the serum sodium. Within 2 days his serum sodium had fallen to 126 mmol/1. Citalopram was withdrawn and mirtazapine was used as an alternative antidepressant with good effect and without any reduction in serum sodium. 

Reversible peripheral edema has been reported in five women taking the proton pump inhibitors omeprazole, lansoprazole, or pantoprazole for 7-15 days for peptic disorders in recommended standard doses (29). Edema disappeared within 2-3 days of withdrawal and reappeared in all five patients after re-exposure. High-dose intravenous infusions of omeprazole and pantoprazole (8 mg/hour) caused peripheral edema in three of six young female volunteers and two of six female volunteers respectively. The edema disappeared within 24 hours of stopping the infusion. Similar high doses of omeprazole did not produce edema in male volunteers. Subsequent studies performed on 10 female volunteers to elucidate the cause of the edema did not show any changes in concentrations of serum hormones or Cl esterase inhibitor. 

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