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  1. bookVolume 18 (2017): Issue 2 (June 2017)
Current Problems of Psychiatry's Cover Image
Current Problems of Psychiatry
Journal Details
License
Format
Journal
eISSN
2353-8627
First Published
30 Mar 2016
Publication timeframe
4 times per year
Languages
English
access type Open Access

Hiponatremia in the practice of a psychiatrist. Part 2: psychogenic polydipsia

Aneta Gerhant,
Aneta Gerhant,
Maciej Słotwiński,
Maciej Słotwiński,
Olga Hołownia,
Olga Hołownia,
Ewa Stelmach and
Ewa Stelmach and
Marcin Olajossy
Marcin Olajossy
Published Online: 01 Sep 2017
Volume & Issue: Volume 18 (2017) - Issue 2 (June 2017)
Page range: 138 - 152
Received: 08 Mar 2017
Accepted: 31 May 2017
Current Problems of Psychiatry's Cover Image
Current Problems of Psychiatry
Journal Details
License
Format
Journal
eISSN
2353-8627
First Published
30 Mar 2016
Publication timeframe
4 times per year
Languages
English
Abstract

Objective. The study is the second part of the literature review on hyponatremia in patients with diagnosed mental disorders. This article focuses on psychogenic polydipsia as, along with the SIADH, one of the two most common causes of hyponatremia in the mentioned group of patients.

Method: The literature review was based on searching the Medline, the Google Scholar and the Ebsco databases in Polish and English by entering the following phrases: psychogenic polydipsia, the psychosis – intermittent hyponatremia – polydipsia syndrome, water intoxication.

Discussion: Psychogenic polydipsia occurs in up to 25% of patients treated for mental disorders. It most frequently concerns patients with schizophrenia. 30% of patients with psychogenic polydipsia suffer from hyponatremia with or without symptoms of water intoxication. In the etiology of psychogenic polydipsia, the influence of dopaminergic and noradrenergic neurotransmission has been considered, as well as angiotensin, which is claimed to have dipsogenic properties. In order to reduce the severity of the disorder, attempts have been made to administer the following groups of medications: β-blockers, opioid receptor antagonists, angiotensin convertase inhibitors and angiotensin receptor antagonists. Other methods include replacing classic antipsychotic drugs with clozapine. There are also reports of a reduced severity of polydipsia with hyponatremia after introducing risperidone and olanzapine. Preventing episodes of water intoxication in patients with psychogenic polydipsia requires the monitoring of their body weight and a suitable reduction of fluid intake by them.

Results: Mentally ill patients, especially those with chronic schizophrenia, should be monitored for psychogenic polydipsia and the concomitant hyponatremia.

Keywords

  • psychogenic polydipsia
  • hyponatremia
  • water intoxication

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