Polidypsia diagnosis in psychiatric unit Review article
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Published:
Dec 31, 2017
Keywords:
psychogenic polydipsia, hyponatraemia, schizophrenia, water intoxication, laboratory tests, weight gain
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Abstract
Primary polydipsia, drinking water in excess without medical cause, is present in 10% of persistently ill psychiatric inpatients. When polydipsia is associated with schizophrenia, mortality increase in comparison to other schizophrenics without excessive fluid intake. It appears to be reasonable to apply reliable diagnostic procedures focused on identifying polydipsia, especially with episodic and intermittent course.
In this review article, we discuss various diagnostic criteria proposed for this syndrome. Methods designed for clinical screening such as measures of specific gravity of urine (SPGU) and normalised diurnal weight gain (NDWG) are presented and application of each other is discussed using data from selected epidemiological studies. Problems with staff observations are also briefly reviewed.
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References
1. Adrogue HJ, Madias N.E. Hyponatremia. N Engl J Med 2000; 342: 1581-1589.
2. Akkaya C, Sarandol A, Sivrioglu EY et al. A patient using ziprasidone with polydipsia, seizure, hyponatremia and rhabdomyolysis. Prog NeuroPsychopharmacol Biol Psychiatry 2006; 30: 1535-1538.
3. Al-Mufti HI, Arieff A. Capropril-induced hyponatremia with irreversible neurologic damage. Am J Med 1985; 79: 769-771.
4. Amlal H, Chen Q, Habo K et al. Fasting downregulates renal water channel A P2 and causes polyuria. Am J Physiol Renal Physiol 2001; 280: F513-F523.
5. Ananth J, Lin KM. SIADH: a serious side effect of psychotropic drugs. Int J Psychiatry Med 1987; 16: 401-401.
6. Ances BM, Vitaliani R, Taylor RA et al. Treatment-responsive limbic encephalitis identified by neutrofil antibodies: MRI and PET correlates. Brain 2005; 128: 1764-1777.
7. Bellino S, Paradiso E, Bogetto F. Oxcarbazepine in the treatment of borderline personality disorder: a pilot study. J Clin Psychiatry 2005; 66: 1111-1115.
8. Bersani G, Pesaresi L, Orlandi V. Atypical antipsychotics and polydipsia: a cause or a treatment? Hum Psychopharmacol Clin Exp 2007; 22: 103-107.
9. Bouman WP, Pinner G, Johnson H. Incidence of selective serotonin reuptake inhibitor (SSRI) induced hyponatraemia due to the syndrome of inappropriate antidiuretic hormone (SIADH) secretion in the elderly. Int J Geriatr Psychiatry 1998; 13: 12-15.
10. Canuso CM, Goldman MB. Clozapine restores water balance in schizophrenic patients with polydipsia-hyponatremia syndrome. J Neuropsychiatry Clin Neurosci 1999; 11: 86-90.
11. Catalano G, Kanfer S, Catalano M et al. The role of sertraline in a patient with recurrent hyponatremia. Gen Hosp Psychiatry 1996; 18: 278-283.
12. Chow KM, Szeto CC, Kwan BC et al. Influence of climate on the incidence of thiazide-induced hyponatraemia. Int J Clin Pract 2007; 61(3): 449-452.
13. Clark WF, Kortas C, Suri RS et al. Excessive fluid intake as a novel cause of proteinuria. CMAJ 2008; 178: 173-175.
14. Costanzo ES, Antes LM, Christensen AJ. Behavioral and medical treatment of chronic polydipsia in a patient with schizophrenia and diabetes insipidus. Psychosom Med 2004; 66: 283-286.
15. de Leon J. Polydipsia a study in a long-term psychiatric unit. Eur Arch Psychiatry Clin Neurosci 2003; 253: 37-39.
16. de Leon J, Dadvand M, Canuso C et al. Polydipsia and Water Intoxication in a Long Term Psychiatric Hospital. Biol Psychiatry 1996; 40: 28-34.
17. de Leon J, Tracy J, McCann E et al. Schizophrenia and tobacco smoking: a replication study in another US psychiatric hospital. Schizophr Res 2002; 56: 55-65.
18. Decaux G, Soupart A, Vassart G. Non-peptide arginine-vasopressin antagonists: the vaptans. Lancet 2008; 371: 1624-1632.
19. Delva NJ, Chang A, Hawken ER et al. Effects of clonidine in schizophrenic patients with primary polydipsia. Three single case studies. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26: 387-392.
20. Draper B, Berman K. Tolerability of selective rerotonin reuptake inhibitors (review article). Drugs Aging 2008; 25: 501-519.
21. Durst RY, Pipek R, Levy Y. Hyponatremia caused by omeprazole treatment. Am J Med 1994; 97: 400-401.
22. Edoute Y, Davids MR, Johnston C et al. An integrative physiological approach to polyuria and hyponatraemia: a "double- take" on the diagnosis and therapy in a patient with schizophrenia. J Med 2003; 96: 531-540.
23. Ferrier IN. Water intoxication in patients with psychiatric illness. Br Med J 1985; 146: 1594-1596.
24. Freudenreich O, Stern TA. Clinical experience with the management of schizophrenia in the general hospital. Psychosomatics 2003; 44: 12-23.
25. Geschwind M, Meng Tan K, Lennon V et al. Voltage-gated potassium channel autoimmunity mimicking Creutzfeldt-Jakob disease. Arch Neurol 2008; 65: 1341-1346.
26. Gibson CAM, Stewart JT. Treatment of psychogenic polydipsia with pindolol. J Clin Psychopharmacol 2006; 26: 99-100.
27. Goldman M, Gnerlich J, Hussain N. Neuroendocrine responses to a cold pressor stimulus in polydipsic hyponatremic and in matched schizophrenic patients. Neuropsychopharmacology 2007; 32: 1611-1621.
28. Goldman M, Marlow-O'Connor M, Torres I et al. Diminished plasma oxytocin in schizophrenic patients with neuroendocrine dysfunction and emotional deficits. Schizophr Res 2008; 98: 247-255.
29. Goldman MB. Effect of adjunctive cortisol on serum sodium in a polydipsic hyponatremic schizophrenic patient. Prog Neuropsychopharmacol Biol Psychiatry 2000; 24: 233-239.
30. Goldman MB, Blake L, Marks R et al. Association of nonsupression of cortisol on the DST with primary polydipsia in chronic schizophrenia. Am J Psychiatry 1993; 150: 653-655.
31. Goldsmith SR. Is there a cardiovascular rationale for the use of combined vasopressin V1a/V2 receptor antagonists? Am J Med 2006; 119: S93-S96.
32. Greendyke RM, Bernhardt AJ, Tasbas HE et al. Polydipsia in chronic psychiatric patients: therapeutic trials of clonidine and enalapril. Neuropsychopharmacology 1998; 18: 272-281.
33. Hawken E, Crookall JM, Reddick D et al. Mortality over a 20-year period in patients with primary polydipsia associated with schizophrenia: a retrospective study. Schizophr Res 2009; 107: 128-133.
34. Hayashi T, Ishida Y, Miyashita T et al. Fatal water intoxication in a schizophrenic patient – an autopsy case. J Clin Forens Med 2005; 12: 157-159.
35. Holtschmidt-Taschner B, Soyka M. Hyponatremia – induced seizure during carbamazepine treatment. World J Biol Psychiatry 2007; 8: 51-53.
36. Hoorn EJ, Halperin ML, Zietse R. Diagnostic approach to a patient with hyponatremia: traditional versus physiology-based options. J Med 2005; 98: 529-540.
37. Hoskins RG, Sleeper FH. Organic functions in schizophrenia. Arch Neurol Psychiatry 1933; 30: 123-140.
38. Howland R. Unusual and serious adverse effects of SSRIs – recognition and management. J Psychosocial Nurs Ment Health Serv 2007; 45: 15-18.
39. Illowsky BP, Kirch DG. New information on polydipsia and hyponatremia in psychiatric patients. Am J Psychiatry 1988; 145: 1039-1039.
40. Ishikawa SE, Saito T, Fukagawa A et al. Close association of urinary excretion of aquaporin-2 with appropriate and inappropriate arginine vasopressin-dependent antidiuresis in hyponatremia in elderly subjects. J Clin Endocrinol Metab 2001; 86: 1665-1671.
41. Israni RK, Kasbekar N, Haynes K et al. Use of antiepileptic drugs in patients with kidney disease. Semin Dial 2006; 19: 408-416.
42. Jessani M, Montgomery J. Lack of association between antipsychotics and hyponatremia in chronic schizophrenia. Schizophr Res 2006; 83: 307-309.
43. Josiassen RC, Goldman M, Jessani M et al. Double-blind, placebo-controlled, multicenter trial of a vasopressin V2-receptor antagonist in patients with schizophrenia and hyponatremia. Biol Psychiatry 2008; 64: 1097-1100.
44. Kawai N, Baba A, Suzuki T et al. Roles of arginine vasopressin and atrial natriuretic peptide in polydipsia-hyponatremia of schizophrenic patients. Psychiatry Res 2001; 101: 39-45.
45. Kawai N, Sakai T, Kurita H et al. A relationship between urine specific gravity and hyponatremia in hospitalized schizophrenic patients. Psychiatry Res 1999; 87: 57-64.
46. Koczapski AB, Millson R. Individual differences in serum sodium levels in schizophrenic men with self-induced water intoxication. Am J Psychiatry 1989; 146: 1614-1615.
47. Kopala LC, Good KP, Koczapski AB et al. Olfactory deficits in patients with schizophrenia and severe polydipsia. Biol Psychiatry 1998; 43: 497-502.
48. Kudoh A. Perioperative management for chronic schizophrenic patients. Anesth Analg 2005; 101: 1867-1872.
49. Kurokawa Y, Ishizaki E, Inaba K. Cerebral swelling in severe hyponatremia caused by water intoxication in a schizophrenic patient. CMIG Extra: Cases 2004; 28: 40-45.
50. Kuz GM, Manssourian A. Carbamazepine-induced hyponatremia: assesment of risk factors. Ann Pharmacother 2005; 39: 1943-1946.
51. Lawson WB, Williams B, Passion R. Effects of captopril on psychosis and disturbed water regulation. Psychopharmacol Bull 1988; 24: 176-178.
52. Lemmens-Gruber R, Kamyar M. Vasopressin antagonists. Cell Mol Life Sci 2006; 63: 1766-1779.
53. Lerner VE, Miodownik C, Libov I et al. Unusual combination: polydipsia with hyponatremia in a schizophrenic patient. Isr J Psychiatry Relat Sci 2000; 37: 37-40.
54. Lyster C, Miller AL, Seidel D et al. Polydipsia and clozapine (letter). Hosp Community Psychiatry 1994; 45: 610-611.
55. Malidelis YI, Panayotacopoulou MT, van Heerikhuize JJ et al. Absence of a difference in the neurosecretory activity of supraoptic nucleus vasopressin neurons of neuroleptic-treated schizophrenic patients. Neuroendocrinology 2005; 82: 63-69.
56. May DL. Patient perceptions of self-induced water intoxication. Arch Psychiatr Nurs 1995; 9: 295-304.
57. Meerabux J, Iwayama Y, Sakurai T et al. Association of an orexin 1 receptor 408 val variant with polydipsia-hyponatremia in schizophrenic subjects. Biol Psychiatry 2005; 58: 401-407.
58. Millson RC, Smith AP, Koczapski AB et al. Self-induced water intoxication treated with group psychotherapy. Am J Psychiatry 1993; 150: 825-826.
59. Mimasaka S, Funayama M, Nata M. A sudden death during a saline drip in a schizophrenic patient with polydipsia. Leg Med (Tokyo) 2004; 6: 190-193.
60. Miyagawa CI. The pharmacologic management of the syndrome of inappropriate secretion of antidiuretic hormone. Drug Intel Clin Pharm 1986; 20: 527-530.
61. Montgomery JH, Tekell JL. Adjunctive quetiapine treatment of the polydipsia, intermittent hyponatremia and psychosis syndrome: a case report (letter). J Clin Psychiatry 2003; 64: 339-341.
62. Movig KLL, Leufkens HGM, Lenderink AW et al. Association between antidepressant drug use and hyponatraemia: a case-control study. J Clin Pharmacol 2002; 53: 363-369.
63. Oades RD, Daniels R. Subclinical polydipsia and polyuria in young patients with schizophrenia or obsessive-compulsive disorder vs normal controls. Prog Neuropsychopharmacol Biol Psychiatry 1999; 23: 1329-1344.
64. Okazaki M, Ito M, Kato M. Effects of polydipsia-hyponatremia on seizures in patients with epilepsy. Psychiatry Clin Neurosci 2007; 61: 330-332.
65. Ohsawa H, Kishimoto T, Hirai M et al. An epidemiological study on hyponatremia in psychiatric patients in mental hospitals in Nara Prefecture. Jpn J Psychiatry Neurol 1992; 46: 883-889.
66. Ozgur-Ilhan I, Demirbas H, Yalcin GA et al. Alcoholic case of central pontine myelinolysis with mainly cerebellar signs. Eur Addict Res 2005; 11: 155-156.
67. Ozsoy S, Basturk M, Esel E. Cerebellar syndrome in a patient with pneumonia under lithium treatment: A case report. Prog Neuropsychopharmacology Biol Psychiatry 2006; 30: 1532-1534.
68. Palladino A. Hyponatremia associated with carbamazepine therapy. Am J Psychiatry 1986; 143: 1190.
69. Petersson I, Nilsson G, Hansson BG et al. Water intoxication associated with non-steroidal anti-inflammatory drug therapy. Acta Med Scand 1987; 221: 221-223.
70. Pollock BG. Adverse reactions of antidepressants in elderly patients. J Clin Psychiatry 1999; 60: 4-8.
71. Pratoomsri W, Yatham LN, Sohn CH et al. Oxcarbazepine add-on in the treatment of refractory bipolar disorder. Bipolar Disorders 2005; 7: 37-42.
72. Ranta A, Wooten F. Hyponatremia due to an additive effect of carbamazepine and tiazide diuretics. Epilepsia 2004; 45: 879.
73. Riggio S. Psychiatric manifestations of nonconvulsive status epilepticus. Mt Sinai J Med 2006; 73: 960-966.
74. Samaan Z. Subacute alteration in level if consciousness in a woman with psychotic depression (letter). Rev Psychiatr Neurosci 2008; 33: 280.
75. Schmitz B, Trimble MR. Carbamazepine and PIP-syndrome in temporal lobe epilepsy. Epilepsy Res 1995; 22: 215-220.
76. Schnur DB, Frick S, Smith S. Temporal stability of polydipsia-hyponatremia. Schizophr Res 1997; 26: 199-202.
77. Shevitz SA, Jameison RC, Petrie WM et al. Compulsive water drinking treated with high dose propranolol. J Nerv Ment Dis 1980; 168: 246-248.
78. Shutty Jr MS. Case report: recurrent pseudocyesis in a male patient with psychosis, intermittent hyponatremia and polydipsia. Psychosom Med 1993; 55: 146-148.
79. Shutty Jr MS, Leadbetter RA, McCulley K. Diurnal urine volume estimates in schizophrenic patients with polydipsia during water-loaded versus nonloaded states. Biol Psychiatry 1997; 41: 374-376.
80. Shutty Jr MS, McCulley K, Pigott B. Association between stereotypic behavior and polydipsia in chronic schizophrenic patients. J Behav Ther Exp Psychiatry 1995; 26: 339-343.
81. Siegel AJ. Hyponatremia in psychiatric patients: update on evaluation and management. Harv Rev Psychiatry 2008; 16: 13-24.
82. Siegler EL, Tamres D, Berlin JA et al. Risk factors for the development of hyponatremia in psychiatric inpatients. Arch Intern Med 1995; 155: 953-957.
83. Singh S, Padi MH, Bullard H et al. Water intoxication in psychiatric patients. Br J Psychiatry 1985; 146: 127-131.
84. Smith JC, Siddique H, Corrall RJM. Misinterpretation of serum cortisol in a patient with hyponatraemia. BMJ 2004; 328: 215-216.
85. Song J, Hu X, Khan O et al. Increased blood pressure, aldosterone activity and regional diffrerences in renal ENaC protein during vasopressin escape. Am J Physiol Renal Physiol 2004; 287: F1076-F1083.
86. Taskapan C, Sahin I, Taskapan H et al. Possible malignant neuroleptic syndrome that associated with hypothyroidism. Prog Neuropsychopharmacol Biol Psychiatry 2005; 29: 745-748.
87. Tenyi T, Voros V. Succesful switch to olanzapine after rhabdomyolysis caused by water intoxication and clozapine use. Pharmacopsychiatry 2006; 39: 157-158.
88. Torres IJ, Keedy S, Marlow-O'Connor M et al. Neuropsychological impairment in patients with schizophrenia and evidence of hyponatremia and polydipsia. Neuropsychology 2009; 23: 307-314.
89. Verghese C, de Leon J, Josiassen RC. Problems and progress in the diagnosis and treatment of polydipsia and hyponatremia. Schizophr Bull 1996; 22: 455-464.
90. Verhoeven A, Musch W, Decaux G. Treatment of the polydipsia- hyponatremia syndrome with urea. J Clin Psychiatry 2005; 66: 1372-1375.
91. Vieweg WVR, Illowsky Karp B. Severe hyponatremia in the polydipsia-hyponatremia syndrome. J Clin Psychiatry 1994; 55: 355-360.
92. Vieweg WVR, Weiss NM, David JJ et al. Treatment of psychosis, intermittent hyponatremia and polydipsia (PIP Syndrome) using lithium and phenytoin. Biol Psychiatry 1988; 23: 25-30.
93. Wakita M, Matsuoka H, Hamada R et al. Hyponatremia upon resumption of paroxetine therapy. Intern Med 2005; 44: 240-242.
94. Webber MA, Ofalabi I, Mahmud W et al. Losartan for treatment of psychogenic polydipsia (letter). Ann Pharmacother 2004; 38: 1750.
95. Woźniak PA, Olędzka-Oręziak M, Wiktorowicz M et al. Polidypsja pierwotna u pacjenta ze schizofrenią paranoidalną: opis przypadku. Postępy Psychiatrii i Neurologii 2010; 19(2): 165-172.
96. Yeh YW, Kuo SC, Chen CY et al. Mimicking catatonic symptoms: A head injury induced acute hyponatremia complicated by rhabomyolysis in a patient with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33: 731-732.
97. Yoon B, Shim YS, Chung SW. Central pontine and extrapontine myelinolysis after alcohol withdrawal. Alcohol Alcohol 2008; 43: 647-649.
98. Zaidi AN. Rhabdomyolysis after correction of hyponatremia in psychogenic polydipsia possibly complicated by ziprasidone. Ann Pharmacother 2005; 39: 1726-1731.
99. Atsariyasing W, Goldman MB. A systematic review of the ability of urine concentration to distinguish antipsychotic-from psychosis-induced hyponatremia. Psychiatry Res 2014; 217: 129-133.
100. Załuska M. Diagnoza i terapia hiponatremii u pacjenta z zaburzeniami psychicznymi. Farmakoterapia w Psychiatrii i Neurologii 2005; 2: 155-166.
101. Zink M, Sartorius A, Lederbogen F. Remission of polydipsia as antipsychotic effect of clozapine. Eur Psychiatry 2004; 19: 320-321.
2. Akkaya C, Sarandol A, Sivrioglu EY et al. A patient using ziprasidone with polydipsia, seizure, hyponatremia and rhabdomyolysis. Prog NeuroPsychopharmacol Biol Psychiatry 2006; 30: 1535-1538.
3. Al-Mufti HI, Arieff A. Capropril-induced hyponatremia with irreversible neurologic damage. Am J Med 1985; 79: 769-771.
4. Amlal H, Chen Q, Habo K et al. Fasting downregulates renal water channel A P2 and causes polyuria. Am J Physiol Renal Physiol 2001; 280: F513-F523.
5. Ananth J, Lin KM. SIADH: a serious side effect of psychotropic drugs. Int J Psychiatry Med 1987; 16: 401-401.
6. Ances BM, Vitaliani R, Taylor RA et al. Treatment-responsive limbic encephalitis identified by neutrofil antibodies: MRI and PET correlates. Brain 2005; 128: 1764-1777.
7. Bellino S, Paradiso E, Bogetto F. Oxcarbazepine in the treatment of borderline personality disorder: a pilot study. J Clin Psychiatry 2005; 66: 1111-1115.
8. Bersani G, Pesaresi L, Orlandi V. Atypical antipsychotics and polydipsia: a cause or a treatment? Hum Psychopharmacol Clin Exp 2007; 22: 103-107.
9. Bouman WP, Pinner G, Johnson H. Incidence of selective serotonin reuptake inhibitor (SSRI) induced hyponatraemia due to the syndrome of inappropriate antidiuretic hormone (SIADH) secretion in the elderly. Int J Geriatr Psychiatry 1998; 13: 12-15.
10. Canuso CM, Goldman MB. Clozapine restores water balance in schizophrenic patients with polydipsia-hyponatremia syndrome. J Neuropsychiatry Clin Neurosci 1999; 11: 86-90.
11. Catalano G, Kanfer S, Catalano M et al. The role of sertraline in a patient with recurrent hyponatremia. Gen Hosp Psychiatry 1996; 18: 278-283.
12. Chow KM, Szeto CC, Kwan BC et al. Influence of climate on the incidence of thiazide-induced hyponatraemia. Int J Clin Pract 2007; 61(3): 449-452.
13. Clark WF, Kortas C, Suri RS et al. Excessive fluid intake as a novel cause of proteinuria. CMAJ 2008; 178: 173-175.
14. Costanzo ES, Antes LM, Christensen AJ. Behavioral and medical treatment of chronic polydipsia in a patient with schizophrenia and diabetes insipidus. Psychosom Med 2004; 66: 283-286.
15. de Leon J. Polydipsia a study in a long-term psychiatric unit. Eur Arch Psychiatry Clin Neurosci 2003; 253: 37-39.
16. de Leon J, Dadvand M, Canuso C et al. Polydipsia and Water Intoxication in a Long Term Psychiatric Hospital. Biol Psychiatry 1996; 40: 28-34.
17. de Leon J, Tracy J, McCann E et al. Schizophrenia and tobacco smoking: a replication study in another US psychiatric hospital. Schizophr Res 2002; 56: 55-65.
18. Decaux G, Soupart A, Vassart G. Non-peptide arginine-vasopressin antagonists: the vaptans. Lancet 2008; 371: 1624-1632.
19. Delva NJ, Chang A, Hawken ER et al. Effects of clonidine in schizophrenic patients with primary polydipsia. Three single case studies. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26: 387-392.
20. Draper B, Berman K. Tolerability of selective rerotonin reuptake inhibitors (review article). Drugs Aging 2008; 25: 501-519.
21. Durst RY, Pipek R, Levy Y. Hyponatremia caused by omeprazole treatment. Am J Med 1994; 97: 400-401.
22. Edoute Y, Davids MR, Johnston C et al. An integrative physiological approach to polyuria and hyponatraemia: a "double- take" on the diagnosis and therapy in a patient with schizophrenia. J Med 2003; 96: 531-540.
23. Ferrier IN. Water intoxication in patients with psychiatric illness. Br Med J 1985; 146: 1594-1596.
24. Freudenreich O, Stern TA. Clinical experience with the management of schizophrenia in the general hospital. Psychosomatics 2003; 44: 12-23.
25. Geschwind M, Meng Tan K, Lennon V et al. Voltage-gated potassium channel autoimmunity mimicking Creutzfeldt-Jakob disease. Arch Neurol 2008; 65: 1341-1346.
26. Gibson CAM, Stewart JT. Treatment of psychogenic polydipsia with pindolol. J Clin Psychopharmacol 2006; 26: 99-100.
27. Goldman M, Gnerlich J, Hussain N. Neuroendocrine responses to a cold pressor stimulus in polydipsic hyponatremic and in matched schizophrenic patients. Neuropsychopharmacology 2007; 32: 1611-1621.
28. Goldman M, Marlow-O'Connor M, Torres I et al. Diminished plasma oxytocin in schizophrenic patients with neuroendocrine dysfunction and emotional deficits. Schizophr Res 2008; 98: 247-255.
29. Goldman MB. Effect of adjunctive cortisol on serum sodium in a polydipsic hyponatremic schizophrenic patient. Prog Neuropsychopharmacol Biol Psychiatry 2000; 24: 233-239.
30. Goldman MB, Blake L, Marks R et al. Association of nonsupression of cortisol on the DST with primary polydipsia in chronic schizophrenia. Am J Psychiatry 1993; 150: 653-655.
31. Goldsmith SR. Is there a cardiovascular rationale for the use of combined vasopressin V1a/V2 receptor antagonists? Am J Med 2006; 119: S93-S96.
32. Greendyke RM, Bernhardt AJ, Tasbas HE et al. Polydipsia in chronic psychiatric patients: therapeutic trials of clonidine and enalapril. Neuropsychopharmacology 1998; 18: 272-281.
33. Hawken E, Crookall JM, Reddick D et al. Mortality over a 20-year period in patients with primary polydipsia associated with schizophrenia: a retrospective study. Schizophr Res 2009; 107: 128-133.
34. Hayashi T, Ishida Y, Miyashita T et al. Fatal water intoxication in a schizophrenic patient – an autopsy case. J Clin Forens Med 2005; 12: 157-159.
35. Holtschmidt-Taschner B, Soyka M. Hyponatremia – induced seizure during carbamazepine treatment. World J Biol Psychiatry 2007; 8: 51-53.
36. Hoorn EJ, Halperin ML, Zietse R. Diagnostic approach to a patient with hyponatremia: traditional versus physiology-based options. J Med 2005; 98: 529-540.
37. Hoskins RG, Sleeper FH. Organic functions in schizophrenia. Arch Neurol Psychiatry 1933; 30: 123-140.
38. Howland R. Unusual and serious adverse effects of SSRIs – recognition and management. J Psychosocial Nurs Ment Health Serv 2007; 45: 15-18.
39. Illowsky BP, Kirch DG. New information on polydipsia and hyponatremia in psychiatric patients. Am J Psychiatry 1988; 145: 1039-1039.
40. Ishikawa SE, Saito T, Fukagawa A et al. Close association of urinary excretion of aquaporin-2 with appropriate and inappropriate arginine vasopressin-dependent antidiuresis in hyponatremia in elderly subjects. J Clin Endocrinol Metab 2001; 86: 1665-1671.
41. Israni RK, Kasbekar N, Haynes K et al. Use of antiepileptic drugs in patients with kidney disease. Semin Dial 2006; 19: 408-416.
42. Jessani M, Montgomery J. Lack of association between antipsychotics and hyponatremia in chronic schizophrenia. Schizophr Res 2006; 83: 307-309.
43. Josiassen RC, Goldman M, Jessani M et al. Double-blind, placebo-controlled, multicenter trial of a vasopressin V2-receptor antagonist in patients with schizophrenia and hyponatremia. Biol Psychiatry 2008; 64: 1097-1100.
44. Kawai N, Baba A, Suzuki T et al. Roles of arginine vasopressin and atrial natriuretic peptide in polydipsia-hyponatremia of schizophrenic patients. Psychiatry Res 2001; 101: 39-45.
45. Kawai N, Sakai T, Kurita H et al. A relationship between urine specific gravity and hyponatremia in hospitalized schizophrenic patients. Psychiatry Res 1999; 87: 57-64.
46. Koczapski AB, Millson R. Individual differences in serum sodium levels in schizophrenic men with self-induced water intoxication. Am J Psychiatry 1989; 146: 1614-1615.
47. Kopala LC, Good KP, Koczapski AB et al. Olfactory deficits in patients with schizophrenia and severe polydipsia. Biol Psychiatry 1998; 43: 497-502.
48. Kudoh A. Perioperative management for chronic schizophrenic patients. Anesth Analg 2005; 101: 1867-1872.
49. Kurokawa Y, Ishizaki E, Inaba K. Cerebral swelling in severe hyponatremia caused by water intoxication in a schizophrenic patient. CMIG Extra: Cases 2004; 28: 40-45.
50. Kuz GM, Manssourian A. Carbamazepine-induced hyponatremia: assesment of risk factors. Ann Pharmacother 2005; 39: 1943-1946.
51. Lawson WB, Williams B, Passion R. Effects of captopril on psychosis and disturbed water regulation. Psychopharmacol Bull 1988; 24: 176-178.
52. Lemmens-Gruber R, Kamyar M. Vasopressin antagonists. Cell Mol Life Sci 2006; 63: 1766-1779.
53. Lerner VE, Miodownik C, Libov I et al. Unusual combination: polydipsia with hyponatremia in a schizophrenic patient. Isr J Psychiatry Relat Sci 2000; 37: 37-40.
54. Lyster C, Miller AL, Seidel D et al. Polydipsia and clozapine (letter). Hosp Community Psychiatry 1994; 45: 610-611.
55. Malidelis YI, Panayotacopoulou MT, van Heerikhuize JJ et al. Absence of a difference in the neurosecretory activity of supraoptic nucleus vasopressin neurons of neuroleptic-treated schizophrenic patients. Neuroendocrinology 2005; 82: 63-69.
56. May DL. Patient perceptions of self-induced water intoxication. Arch Psychiatr Nurs 1995; 9: 295-304.
57. Meerabux J, Iwayama Y, Sakurai T et al. Association of an orexin 1 receptor 408 val variant with polydipsia-hyponatremia in schizophrenic subjects. Biol Psychiatry 2005; 58: 401-407.
58. Millson RC, Smith AP, Koczapski AB et al. Self-induced water intoxication treated with group psychotherapy. Am J Psychiatry 1993; 150: 825-826.
59. Mimasaka S, Funayama M, Nata M. A sudden death during a saline drip in a schizophrenic patient with polydipsia. Leg Med (Tokyo) 2004; 6: 190-193.
60. Miyagawa CI. The pharmacologic management of the syndrome of inappropriate secretion of antidiuretic hormone. Drug Intel Clin Pharm 1986; 20: 527-530.
61. Montgomery JH, Tekell JL. Adjunctive quetiapine treatment of the polydipsia, intermittent hyponatremia and psychosis syndrome: a case report (letter). J Clin Psychiatry 2003; 64: 339-341.
62. Movig KLL, Leufkens HGM, Lenderink AW et al. Association between antidepressant drug use and hyponatraemia: a case-control study. J Clin Pharmacol 2002; 53: 363-369.
63. Oades RD, Daniels R. Subclinical polydipsia and polyuria in young patients with schizophrenia or obsessive-compulsive disorder vs normal controls. Prog Neuropsychopharmacol Biol Psychiatry 1999; 23: 1329-1344.
64. Okazaki M, Ito M, Kato M. Effects of polydipsia-hyponatremia on seizures in patients with epilepsy. Psychiatry Clin Neurosci 2007; 61: 330-332.
65. Ohsawa H, Kishimoto T, Hirai M et al. An epidemiological study on hyponatremia in psychiatric patients in mental hospitals in Nara Prefecture. Jpn J Psychiatry Neurol 1992; 46: 883-889.
66. Ozgur-Ilhan I, Demirbas H, Yalcin GA et al. Alcoholic case of central pontine myelinolysis with mainly cerebellar signs. Eur Addict Res 2005; 11: 155-156.
67. Ozsoy S, Basturk M, Esel E. Cerebellar syndrome in a patient with pneumonia under lithium treatment: A case report. Prog Neuropsychopharmacology Biol Psychiatry 2006; 30: 1532-1534.
68. Palladino A. Hyponatremia associated with carbamazepine therapy. Am J Psychiatry 1986; 143: 1190.
69. Petersson I, Nilsson G, Hansson BG et al. Water intoxication associated with non-steroidal anti-inflammatory drug therapy. Acta Med Scand 1987; 221: 221-223.
70. Pollock BG. Adverse reactions of antidepressants in elderly patients. J Clin Psychiatry 1999; 60: 4-8.
71. Pratoomsri W, Yatham LN, Sohn CH et al. Oxcarbazepine add-on in the treatment of refractory bipolar disorder. Bipolar Disorders 2005; 7: 37-42.
72. Ranta A, Wooten F. Hyponatremia due to an additive effect of carbamazepine and tiazide diuretics. Epilepsia 2004; 45: 879.
73. Riggio S. Psychiatric manifestations of nonconvulsive status epilepticus. Mt Sinai J Med 2006; 73: 960-966.
74. Samaan Z. Subacute alteration in level if consciousness in a woman with psychotic depression (letter). Rev Psychiatr Neurosci 2008; 33: 280.
75. Schmitz B, Trimble MR. Carbamazepine and PIP-syndrome in temporal lobe epilepsy. Epilepsy Res 1995; 22: 215-220.
76. Schnur DB, Frick S, Smith S. Temporal stability of polydipsia-hyponatremia. Schizophr Res 1997; 26: 199-202.
77. Shevitz SA, Jameison RC, Petrie WM et al. Compulsive water drinking treated with high dose propranolol. J Nerv Ment Dis 1980; 168: 246-248.
78. Shutty Jr MS. Case report: recurrent pseudocyesis in a male patient with psychosis, intermittent hyponatremia and polydipsia. Psychosom Med 1993; 55: 146-148.
79. Shutty Jr MS, Leadbetter RA, McCulley K. Diurnal urine volume estimates in schizophrenic patients with polydipsia during water-loaded versus nonloaded states. Biol Psychiatry 1997; 41: 374-376.
80. Shutty Jr MS, McCulley K, Pigott B. Association between stereotypic behavior and polydipsia in chronic schizophrenic patients. J Behav Ther Exp Psychiatry 1995; 26: 339-343.
81. Siegel AJ. Hyponatremia in psychiatric patients: update on evaluation and management. Harv Rev Psychiatry 2008; 16: 13-24.
82. Siegler EL, Tamres D, Berlin JA et al. Risk factors for the development of hyponatremia in psychiatric inpatients. Arch Intern Med 1995; 155: 953-957.
83. Singh S, Padi MH, Bullard H et al. Water intoxication in psychiatric patients. Br J Psychiatry 1985; 146: 127-131.
84. Smith JC, Siddique H, Corrall RJM. Misinterpretation of serum cortisol in a patient with hyponatraemia. BMJ 2004; 328: 215-216.
85. Song J, Hu X, Khan O et al. Increased blood pressure, aldosterone activity and regional diffrerences in renal ENaC protein during vasopressin escape. Am J Physiol Renal Physiol 2004; 287: F1076-F1083.
86. Taskapan C, Sahin I, Taskapan H et al. Possible malignant neuroleptic syndrome that associated with hypothyroidism. Prog Neuropsychopharmacol Biol Psychiatry 2005; 29: 745-748.
87. Tenyi T, Voros V. Succesful switch to olanzapine after rhabdomyolysis caused by water intoxication and clozapine use. Pharmacopsychiatry 2006; 39: 157-158.
88. Torres IJ, Keedy S, Marlow-O'Connor M et al. Neuropsychological impairment in patients with schizophrenia and evidence of hyponatremia and polydipsia. Neuropsychology 2009; 23: 307-314.
89. Verghese C, de Leon J, Josiassen RC. Problems and progress in the diagnosis and treatment of polydipsia and hyponatremia. Schizophr Bull 1996; 22: 455-464.
90. Verhoeven A, Musch W, Decaux G. Treatment of the polydipsia- hyponatremia syndrome with urea. J Clin Psychiatry 2005; 66: 1372-1375.
91. Vieweg WVR, Illowsky Karp B. Severe hyponatremia in the polydipsia-hyponatremia syndrome. J Clin Psychiatry 1994; 55: 355-360.
92. Vieweg WVR, Weiss NM, David JJ et al. Treatment of psychosis, intermittent hyponatremia and polydipsia (PIP Syndrome) using lithium and phenytoin. Biol Psychiatry 1988; 23: 25-30.
93. Wakita M, Matsuoka H, Hamada R et al. Hyponatremia upon resumption of paroxetine therapy. Intern Med 2005; 44: 240-242.
94. Webber MA, Ofalabi I, Mahmud W et al. Losartan for treatment of psychogenic polydipsia (letter). Ann Pharmacother 2004; 38: 1750.
95. Woźniak PA, Olędzka-Oręziak M, Wiktorowicz M et al. Polidypsja pierwotna u pacjenta ze schizofrenią paranoidalną: opis przypadku. Postępy Psychiatrii i Neurologii 2010; 19(2): 165-172.
96. Yeh YW, Kuo SC, Chen CY et al. Mimicking catatonic symptoms: A head injury induced acute hyponatremia complicated by rhabomyolysis in a patient with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33: 731-732.
97. Yoon B, Shim YS, Chung SW. Central pontine and extrapontine myelinolysis after alcohol withdrawal. Alcohol Alcohol 2008; 43: 647-649.
98. Zaidi AN. Rhabdomyolysis after correction of hyponatremia in psychogenic polydipsia possibly complicated by ziprasidone. Ann Pharmacother 2005; 39: 1726-1731.
99. Atsariyasing W, Goldman MB. A systematic review of the ability of urine concentration to distinguish antipsychotic-from psychosis-induced hyponatremia. Psychiatry Res 2014; 217: 129-133.
100. Załuska M. Diagnoza i terapia hiponatremii u pacjenta z zaburzeniami psychicznymi. Farmakoterapia w Psychiatrii i Neurologii 2005; 2: 155-166.
101. Zink M, Sartorius A, Lederbogen F. Remission of polydipsia as antipsychotic effect of clozapine. Eur Psychiatry 2004; 19: 320-321.