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The American Journal of Psychiatry, VOL. 130, No. 9

Articles | September 01, 1973

Lithium-Induced Diabetes Insipidus: Manic Symptoms, Brain and Electrolyte Correlates, and Chlorothiazide Treatment

STEVEN T. LEVY; JOHN N. FORREST; GEORGE R. HENINGER

Am J Psychiatry 1973;130:1014-1018.

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Mental Health Career Development Officer, Adult Psychiatry Branch, Psychiatric Assessment Section, National Institute of Mental Health, Building 10, NIH, 9000 Rockville Pike, Bethesda, Md. 20014

Assistant Professor, Renal Section, Department of Medicine, New Haven, Conn.

Associate Professor, Department of Psychiatry, Yale School of Medicine, New Haven, Conn.

1973, the American Psychiatric Association

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Abstract

A patient with lithium-induced, vasopressin-insensitive diabetes insipidus was studied during two consecutive manic episodes that were successfully treated with lithium. Polyuria occurred several days after lithium-induced brain electrical changes were observed, and at serum lithium concentrations close to 1.0 mEq./liter. Polyuria began during a period of behavioral improvement and persisted after the manic symptoms subsided. Polyuria did not occur in association with serum lithium concentrations over 1.8 mEq./liter, and a fourfold increase in sodium intake did not reduce the polyuria. Chlorothiazide reduced polyuria and permitted the patient to continue the lithium treatment.

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