Antidepressants (SSRI) Trigger Hyponatremia, Which Causes Severe Anxiety

• Thousands developed dangerously low sodium — Among the participants, 3,999 went on to develop hyponatremia, defined in this study as blood sodium levels dropping below 125 mmol/L. For perspective, normal sodium sits between 135 and 145 mmol/L, so a fall to 125 is not just a small shift — it represents a level at which seizures, confusion, and hospitalization are likely. That’s why this condition is classified as “profound.”

• Risk spikes quickly after starting medication — The data showed that the highest danger occurred in the first 14 days of treatment. In fact, people who had just begun antidepressants were more than 10 times more likely to develop profound hyponatremia compared to baseline.

• Older adults and women were hit hardest — Elderly women stood out as the most vulnerable group, with nearly 1 in 15 women over 80 years old developing profound hyponatremia after starting treatment. This shows how important age and sex are when predicting side effects — factors that often get overlooked in quick prescribing decisions.

• The problem is too much water retention — SSRIs and venlafaxine disrupt sodium levels through a condition called syndrome of inappropriate antidiuresis (SIADH). In plain terms, these drugs cause your body to release excess antidiuretic hormone, which signals your kidneys to hold onto water.

When your body retains too much water, the sodium in your blood becomes diluted — much like watering down soup — causing the sodium concentration to fall below the level your nerves and muscles need to function properly. The study tracked hospital admissions related to this known mechanism.

• A cycle that feeds itself — When sodium levels crash, patients often feel more restless, fearful, or paranoid. Instead of realizing this is a drug reaction, doctors frequently mislabel it as “worsening anxiety,” leading to higher doses or additional prescriptions. In this way, the treatment creates the very problem it claims to fix.

• A danger long known, but ignored — According to Dinkov, the risks of SSRI-induced hyponatremia have been documented for decades. Yet, warnings remain hidden in fine print, dismissed as rare side effects rather than recognized as central dangers. This silence, he argues, amounts to deliberate negligence: the system profits when patients stay stuck in a loop of drugs and worsening symptoms.

• Sodium is your brain’s power source — Think of sodium as the electrical charge that keeps your brain’s circuits running smoothly. When that charge falls, the system falters — like a phone trying to operate at 5% battery. The result? Mood swings, irrational fears, and panic attacks that are indistinguishable from a severe anxiety disorder.

• Why recognizing the pattern matters — If your anxiety spikes shortly after starting one of these drugs, don’t assume it’s “your condition getting worse.” It’s likely your brain running out of its electrical fuel. Knowing this gives you the power to ask the right questions, demand sodium checks, and avoid being trapped in the cycle of drugs for symptoms the drugs themselves created.

• About 6% of antidepressant users developed hyponatremia — Across all studies, around 6% of people who used antidepressants developed clinically significant hyponatremia. That means about six out of every 100 people prescribed these medications ended up with dangerously low sodium levels. At a global scale involving tens of millions of users, the result translates into millions of people being affected.

• Certain drugs were more dangerous than others — The review ranked specific drugs according to their risk. Fluoxetine (Prozac) and venlafaxine (Effexor) were the most dangerous, producing higher rates of hyponatremia than other antidepressants. By comparison, sertraline (Zoloft) and duloxetine (Cymbalta) carried lower, though still significant, risks.

A separate nationwide analysis of 17,439 patients revealed that sodium problems are not just “rare events.”⁴ About 1 in 10 users developed hyponatremia within three years, with duloxetine standing out as the highest-risk drug in this study. By contrast, bupropion (Wellbutrin XL) and paroxetine (Paxil) had the lowest risk.

• Older adults remain the most vulnerable group — Age was again a decisive factor in this analysis. Elderly populations, especially those over 65, faced the steepest risk of sodium depletion. This means that anyone caring for an aging parent or grandparent taking antidepressants needs to be vigilant for symptoms like dizziness, confusion, or sudden changes in mood — signs that are often mistakenly dismissed as “just getting older.”

• The drug caused her body to hold onto too much water — Doctors found that sertraline triggered SIADH. Her urine tests showed she was losing sodium through urine while her body was still holding onto water — exactly the wrong combination.

• Intensive care was needed to bring her back to safety — To fix the problem, she was admitted to the intensive care unit and given a strong salt solution through an IV, while her fluid intake was limited to just 1 liter a day. Her sodium was raised slowly so her brain wouldn’t swell from sudden changes. Doctors stopped the sertraline permanently, and her sodium levels returned to normal over several days.

• Low sodium raises your risk of falls and broken bones — The woman’s collapse wasn’t just bad luck. Severe hyponatremia makes bones weaker and increases the chance of falls. This creates a cycle of injuries, hospital stays, and declining health. In older adults, even a small imbalance in sodium often sets off serious complications.

• Before any SSRI, anxious people had normal sodium like everyone else — Mean sodium was essentially the same before treatment in both groups, and true hyponatremia was actually a bit less common in the anxiety group than controls (2.2% versus 3.3%). That means anxiety alone was not the driver of low sodium in this dataset; the baseline labs didn’t point to overhydration from nervous drinking either.

• After starting an SSRI, sodium dipped and low-sodium cases rose — Once treatment began, average sodium fell slightly, and the share with hyponatremia went up by about 50%, from 2.6% to 3.9%. The shift happened after the drug, not before it — so if you felt worse or dizzier following a new SSRI, sodium loss is a concrete thing to check.

• Borderline low sodium also became more common on SSRI therapy — “Borderline” low sodium (just under normal but not severely low) increased from 35.3% to 40.7% after SSRI initiation, signaling a wider move toward lower sodium even if not everyone crossed the line into full hyponatremia.

• Anxiety’s “water-drinking” myth didn’t hold up here — The study did not find evidence that anxious adults were overhydrated at baseline; indirect hydration markers were similar to controls, and sodium looked stable before medication start. This shifts attention from the anxiety water-drinking myth — the idea that people with anxiety naturally drink too much water — to medication effects as the actionable point.

1. Fuel your brain with the right foods — Your mind depends on a steady supply of energy. If your cells aren’t producing enough, fatigue and low mood take over. Give your body easy-to-use carbs such as fruit and white rice. Most people do well with around 250 grams per day, and if you’re athletic, you’ll likely need more.

Cut out seed oils and packaged foods high in linoleic acid (LA), which damage your mitochondria — the engines inside your cells. Instead, cook with stable saturated fats like butter from grass fed cows, ghee, or beef tallow. When your cells are properly fueled, your mood and focus naturally improve.

2. Replenish nutrients tied to emotional balance — Low levels of certain vitamins and minerals are often overlooked drivers of depression. Magnesium, for example, helps your nervous system relax and is commonly depleted in stressed individuals.

B vitamins are also important: lack of niacin (B3) is linked to paranoia and agitation, while too little thiamine (B1) contributes to irritability and poor sleep. Load your plate with nutrient-dense foods like grass fed eggs and leafy greens. If diet alone isn’t enough, which is often the case for magnesium, targeted supplements help restore these reserves.

3. Make movement a daily habit — Physical activity is one of the most reliable ways to lift mood naturally. Even light activity such as walking, stretching, or cycling at an easy pace increases circulation, balances hormones, and stimulates feel-good brain chemicals. You don’t have to do long gym sessions — short bursts of enjoyable movement done consistently will lead to results.

4. Let the sun reset your mind and body — Exposure to natural sunlight does more than generate vitamin D — it also boosts endorphins and charges your cellular energy. Aim for outdoor time daily, especially in the morning to set your internal clock.

Blood levels of vitamin D between 60 and 80 ng/mL are ideal for mood stability, so test to see where you stand. If you’ve eaten a diet heavy in seed oils, your skin is more prone to burning; stick with gentler light in the early morning or late afternoon until you’ve eliminated these oils for several months.

5. Restore balance through sleep and relaxation — Sleep is your body’s repair window, and without it, emotional health unravels. Step outside shortly after waking to anchor your circadian rhythm, then create an evening ritual that signals bedtime: dim lights, avoid screens, and make your room completely dark.

During the day, manage stress through practices like slow breathing, meditation, or Emotional Freedom Techniques (EFT). These tools train your body to stay calm so stress hormones don’t dominate your brain.