The role of SSRI –TCA on vasopressin release is circumstantial based on a few case reports and observational studies documenting an association of occurrence of hyponatremia in some (esp. elderly) but not all patients on these medications. However,  the occurrence of hyponatremia in this setting is complex and primarily affects elderly females who may have other risk factors (e.g. thiazide, anti-epileptics, disease states associated with low effective circulation). Moreover, the prevalence of as high as 9% of the study subjects is likely an over-estimate when compared to that in the general population. Nonetheless, SSRI may be associated with higher risk of hyponatremia than TCA.

If we extrapolate to say that SSRI-TCA is detrimental in patients with ADPKD we will be in even more uncertain ground. So I would regard Dr. Steinman’s statement as a soft recommendation.
Personally, I do not restrict the use of antidepressant in ADPKD patients but make sure that it is clinically indicated – TCA may be preferred in this case. I would monitor serum sodium in the treated patients given our practice of recommending high water intake in the PKD patients.