1. bookVolumen 18 (2017): Heft 2 (June 2017)
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License
Format
Zeitschrift
eISSN
2353-8627
Erstveröffentlichung
30 Mar 2016
Erscheinungsweise
4 Hefte pro Jahr
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Englisch
access type Uneingeschränkter Zugang

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

Online veröffentlicht: 01 Sep 2017
Volumen & Heft: Volumen 18 (2017) - Heft 2 (June 2017)
Seitenbereich: 138 - 152
Eingereicht: 08 Mar 2017
Akzeptiert: 31 May 2017
Zeitschriftendaten
License
Format
Zeitschrift
eISSN
2353-8627
Erstveröffentlichung
30 Mar 2016
Erscheinungsweise
4 Hefte pro Jahr
Sprachen
Englisch
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.

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