Many psychiatric patients have polydipsia and polyuria without
identifiable underlying medical causes. Hyponatremia develops in some
polydipsic patients and can progress to water intoxication with such
symptoms as confusion, lethargy, psychosis, and seizures or death. This
syndrome is sometimes called "compulsive water drinking," "psychogenic
polydipsia," and "self-induced water intoxication." Although the underlying
pathophysiology of the syndrome is unclear, several factors have been
implicated in producing polydipsia and symptomatic hyponatremia. These
include a possible hypothalamic defect, the syndrome of inappropriate
secretion of ADH (SIADH), and neuroleptic medication. Evaluation of
psychiatric patients with polydipsia includes a search for other medical
causes of polydipsia, polyuria, hyponatremia, and SIADH. Treatment
modalities currently available include fluid restriction and
medications.Abstract Teaser