Am J Psychiatry 1986; 143:1563-1568
Copyright © 1986 by American Psychiatric Association
Treatment of severe lithium-induced polyuria with amiloride
TR Kosten and JN Forrest
One of the major side effects of lithium is nephrogenic diabetes insipidus.
The established treatment for the disorder is thiazide diuretics, which are
associated with hypokalemia and reduced lithium excretion, predisposing the
patient to lithium toxicity. Amiloride is a new diuretic that reduces
lithium-induced polyuria in animals without affecting lithium or potassium
levels. The authors found that 10-20 mg/day of amiloride given to eight
patients who had become hypokalemic while being treated with
hydrochlorothiazide for lithium-induced nephrogenic diabetes insipidus
increased renal concentrating ability and reduced polyuria. They conclude
that amiloride can be useful in treating lithium-induced nephrogenic
diabetes insipidus and merits future randomized clinical trials.
